Purpose: Femoroacetabular impingement (FAI) is recognized as an etiological risk factor for hip arthritis. The potential for joint preserving surgical techniques that may delay the progression to early arthritis and retard the possibility of arthroplasty at a young age is promising. This study presents the outcome of surgical treatment of FAI through a less invasive technique performed through a modified Smith-Peterson approach without hip dislocation, or arthroscopy.

Method: Using an institutional database, a total of 72 patients (80 hips) with radiographic and clinical diagnosis of FAI who underwent direct anterior femoroacetabular osteoplasty (FAO) were identified. Preoperative and postoperative functional evaluation was performed on these patients. The operative findings were recorded in detail and evaluated with regard to outcome.

Results: Intraoperative diagnosis of labral tear and osteochondral lesions in the anterosuperior acetabulum was confirmed in all cases. The surgical approach provided adequate access to allow labral repair and osteoplasty of the femoral neck and the acetabulum, whenever needed. There were no intraoperative complications. All patients experienced a significant improvement in function as measured by modified Harris hip and SUSHI scores. Majority (85%) of the patients were satisfied with the outcome of the surgery. In addition, Health Survey SF-36 showed most patients felt their health had improved significantly. The predictors of poor outcome were previous hip scope, lack of labrum for repair, large chondral lesions, and workman’s compensation status.

Conclusion: This study presents the early results of a less invasive surgical treatment for femoroacetabular impingement. This ongoing study shows that the described technique seems to be a viable approach for treatment of this painful condition in the young.