Introduction: Femoroacetabular impingement (FAI) has been recently recognized as the main cause of hip pain in sportsmen. We analyse if clinical and functional results of surgical treatment are influenced by preoperative degenerative hip changes.

Materials and Methods: A series of 117 consecutive Ribas mini open procedures (mini open femoroacetabular osteoplasty with labral refixation) were performed in 115 sportsmen with confirmed clinical, radiographic, and MR-arthrography diagnosis of FAI, and were evaluated with a minimum follow up of 4 years (range: 4 – 6,5). According to Tönnis Grade for preoperative radiological degenerative hip stage, the hips were divided into 3 groups: group A/Tönnis 0: 32 hips; group B/Tönnis 1: 61 hips; group C/Tönnis 2: 24 hips. A Combined Clinical Score (CCS), which includes Impingement test, Merle D’Aubigné and WOMAC scores, was used to evaluate the patients before surgery and at 6 weeks, 3 months, 6 months and every year after operation. Satisfactory and unsatisfactory results were obtained and collected. SPSS 10.0 software (SPSS INC, Chicago, Ill) was used for statistical analysis and comparisons were performed by means of chi-squared and Wilcoxon tests; p< 0,05 was considered to be significant.

Results: With CCS method, satisfactory results were obtained in group A (Tönnis 0) in 93,4% of the cases at 12 months, in 96,5% at 24 months, and in 97,8% at the latest follow up of 48 months; in group B (Tönnis 1) satisfactory results were observed in 91,3% of the cases at 12 months, in 91,2% at 24 months, and in 93,6% at 48 months; in group C (Tönnis 2) satisfactory results were obtained in 58,3% of the cases at 12 months, in 55,3% at 24 months, and in 50,1% at 48 months. Differences between groups A and C, as like between groups B and C, were significant (p< 0,001), but not between groups A and B (p> 0,05).

Conclusions: Midterm results of the Ribas mini open procedure for the treatment of femoroacetabular impingement are encouraging, expecially in hips not exceeding Tönnis Grade 1 osteoarthrosis, as results depend directly on degenerative state. If symptomatic patients are treated in early stages, excellent expectancies can be obtained with this procedure already at midterm. In addition, instruction of general physicians and specialists in the diagnosis of FAI is of paramount importance.

Introduction: Higher loosening rate, improvements in metalo n metal bearings and excellent immediate clinico-functional results related with current Standard total hip endoprosthesis, have suposed the rennaisance of the new hip resurfacing implants. In this work we present our experience the first 486 cases and minimal 5 years follow up.

Material and method: From July 2003 to December 2008 486 surface arthroplasties were implanted in our institution (4 bilateral) in 450 patients, 314 males y 136 females, mean age of 46,6 years (16 – 69). 9 BHR, 2 ASR, 3 ADEPT, 5 CORIN, 22 Mitch and 409 CONSERVE PLUS models were implanted. In 454 cases a modified Kocher-Langenbeck posterior approach and in 32 cases Hueter’s anterior approach were carried out. Surgical time, intraoperative bleeding and collected blood in drains, components orientation in AP radiographies, registered complications, Merle d’Aubigné, WOMAC and HHS clínico-funtcional scores were assessed. Statistical analysis was performed by means of chi-squared test and non – parametric tests.

Results: Mean surgical time was 1h 50’ (1h 15’ a 2h 30’), mean intraoperative bleeding 273,4 cc (210 – 360cc), drained blood 224,2 cc (180 – 380cc). During the first year 11 autodonated blood units were retransfused (during the first 5 months patients were encouraged for 1000cc. autodonation). Mean CCD angle was 139,7° (SD 130 – 147) and acetabular inclination 43° (SD 40 – 65°). There were 4 instances of femoral fractures during the first half year after surgery, which required conversiòn to a BFH total endoprosthesis, one too adducted cup (65°), which required only cup exchange. There was a very significant improvement in clinico-functional scores: MDA score improved from 12,9 pts. preoperative (11 – 14) to 17,4 at latest follow-up (15 – 18) (p< 0,001), WOMAC from 46,2 (19 – 67) to 93,2 (79 – 100) (p< 0,001) and HHS from 52,3 (range 42 – 60) to 96,7 (range 89 – 98) (p< 0,001). Main complications were 1 arterial femoral thrombosis, 1 deep venous thrombosis, 1 deep infection that required 2-stages exchange, 4 transient femoral pare-sia. Overall survivorship was 98,97%.

Conclusions: hip resurfacing implantation, when recommendations made by the first authors of these new models are properly carried out, provide excellent clinical-functional results, comparable to non cemented total hip implants, if not better. Longer follow up are required to assess more adequately these implants, although it will not probably mean in the majority of the cases any hip exchange of a standard THA in terms of morbidity and mid-longterm clinical-functional result. This assumption has been taken from our cases converted to a THA with BFH. For this reason we do think absolutely we dispose today a very promising implant for young adults with well stablished hip osteoarthritis.

Introduction and purpose: Femoroacetabular impingement (FAI) has become a well-recognized pathological condition over the last few years and different authors have published good results obtained after surgical treatment using osteoplasty. In this study we analyze the clinical and functional results seen in the first one hundred patients subjected to osteoplasty using a minimally invasive anterior approach.

Materials and methods: We analyzed the first 107 patients treated with a mean follow-up of 26 months (range: 6–41). They are assessed on a scale we drew up ourselves that takes into account the Impingement Test, the Merle D’Aubigné scale and the WOMAC score at 6 weeks, 3 months, 6 months and once a year. Results are classified according to these variables as excellent, good, fair and poor and are analyzed using the chi-square test (SPSS software, p< 0.05). Excellent and good results are considered satisfactory, the others are not.

Results: At 1 year satisfactory results are seen in 91.3 % of Tönnis 1 cases and 93.4% of Tönnis 0 cases; these results are maintained during the second year in 85.1% (p=0.375). On the other hand, in Tönnis 2 cases, only 55.3% good results are seen at 2 years. These differences were significant (p< 0.017).

Conclusions: Treatment of impingement by means of femoroacetabular osteoplasty using our minimally invasive approach results in a high proportion of satisfactory outcomes, especially during stages 0 and 1. However, such is not the case in stage Tönnis 2 cases. Therefore, it is advisable to use this procedure in symptomatic patients during the incipient stages of the condition.