There is an increased risk of fracture following osteoplasty of the femoral neck for cam-type femoroacetabular impingement (FAI). Resection of up to 30% of the anterolateral head–neck junction has previously been considered to be safe, however, iatrogenic fractures have been reported with resections within these limits. We re-evaluated the amount of safe resection at the anterolateral femoral head–neck junction using a biomechanically consistent model. In total, 28 composite bones were studied in four groups: control, 10% resection, 20% resection and 30% resection. An axial load was applied to the adducted and flexed femur. Peak load, deflection at time of fracture and energy to fracture were assessed using comparison groups. There was a marked difference in the mean peak load to fracture between the control group and the 10% resection group (p < 0.001). The control group also tolerated significantly more deflection before failure (p < 0.04). The mean peak load (p = 0.172), deflection (p = 0.547), and energy to fracture (p = 0.306) did not differ significantly between the 10%, 20%, and 30% resection groups. . Any resection of the anterolateral quadrant of the femoral head–neck junction for FAI significantly reduces the load-bearing capacity of the proximal femur. After initial resection of cortical bone, there is no further relevant loss of stability regardless of the amount of trabecular bone resected. Based on our findings we recommend any patients who undergo anterolateral femoral head–neck junction osteoplasty should be advised to modify their post-operative routine until cortical remodelling occurs to minimise the subsequent fracture risk. Cite this article: Bone Joint J 2015;97-B:1214–19

Aims. The aims of this study were to evaluate the abductor function in moderate and severe slipped capital femoral epiphysis (SCFE), comparing the results of a corrective osteotomy at the base of the femoral neck and osteoplasty with 1) in situ epiphysiodesis for mild SCFE, 2) contralateral unaffected hips, and 3) hips from healthy individuals. Patients and Methods. A total of 24 patients (mean age 14.9 years (. sd. 1.6); 17 male and seven female patients) with moderate or severe SCFE (28 hips) underwent base of neck osteotomy and osteoplasty between 2012 and 2015. In situ epiphysiodesis was performed in seven contralateral hips with mild slip. A control cohort was composed of 15 healthy individuals (mean age 16.5 years (. sd. 2.5); six male and nine female patients). The abductor function was assessed using isokinetic dynamometry and range of abduction, with a minimum one-year follow-up. Results. We found no differences in mean peak abductor torque between the hips that underwent osteotomy and those that received in situ epiphysiodesis (p = 0.63), but the torque was inferior in comparison with contralateral hips without a slip (p < 0.01) and hips from control individuals (p < 0.001). The abduction strength was positively correlated with the range of hip abduction (R = 0.36; p < 0.001). Conclusion. Although the abductor strength was not restored to normal levels, moderate and severe SCFE treated with osteotomy at the base of the femoral neck and osteoplasty showed abductor function similar to in situ epiphysiodesis in hips with less severe displacement. Cite this article: Bone Joint J 2018;100-B:1524–32

Introduction. Bony deformities in the hip that cause femoroacetabular impingement (FAI) can be resected in order to delay the onset of osteoarthritis and improve hip range of motion. However, achieving accurate osteoplasty arthroscopically is challenging because the narrow hip joint capsule limits field of view. Recently, image-based navigation using a preoperative plan has been shown to improve the accuracy of femoral bone surfaces following arthroscopic osteoplasty for FAI. The current standard for intraoperative monitoring, 3D x-ray fluoroscopy, is accurate at the initial registration step to within 0.8±0.5mm but involves radiation. Intraoperative 3D ultrasound (US) is a promising radiation-free alternative for providing real-time visual feedback during FAI osteoplasty. The objective was to determine if intraoperative 3D US of the femoral head/neck region can be registered to a CT-based preoperative plan with comparable accuracy to fluoroscopic navigation in order to visualise progress during arthroscopic FAI osteoplasty. Methods. The experiment used a plastic femur model that had a cam deformity on the femoral head/neck. Thirty metal fiducial markers were placed on the US-accessible anterior and lateral surfaces of the femur. A CT image was acquired and reconstructed, then used to develop a preoperative plan for resection of the cam deformity. Twenty-two sets of 3D US data were then gathered from the phantom using a clinical ultrasound machine and 3D transducer while the phantom was submerged in water. US surfaces from the anterior/lateral regions of the femur were extracted using a recently proposed image processing algorithm. Fiducials in the US volume were manually registered to corresponding CT fiducials to provide a reference standard registration. The reference standard fiducial registration error (FRE) was measured as the average distance between corresponding fiducials. After fiducial-based registration, each US surface was randomly misaligned and re-registered using a coherent point-drift algorithm. The resulting surface registration error (SRE) was measured using average distance between US and CT surfaces. Finally, a plastic model of the preoperative cam deformity resection plan was 3D-printed to represent the postoperative femur. Five US scans were acquired of the postoperative model near the femoral head/neck. Each US scan was initialised for 20 trials using three reference points, and then registered using coherent point drift. Surgical outcome accuracy was reported using final surface registration error (fSRE). Results. The reference standard FRE was 0.41±0.19mm. The distance between surfaces following misalignment and re-registration for all 2200 automated registration trials was similarly small (SRE = 0.31±0.04mm) and well below the required clinical limit. Lastly, the postoperative model was accurately registered to corresponding US scans (fSRE = 0.58±0.07mm). Qualitative visualisation showed good surface matching following US to CT registration. Conclusion. Initial registration between intraoperative 3D US and preoperative CT is critical for accurate visualisation of surgical progress during FAI osteoplasty. Given spatial initialisation, the achievable registration accuracy of 3D US to CT is 0.31±0.04mm (SRE) which is well within the fluoroscopy standard, 0.8±0.5mm. The results suggest strong potential for ultrasound to guide computer-assisted arthroscopic FAI osteoplasty

Purpose. This report compares midterm results of open neck osteoplasty + neck osteotomy vs arthroscopic osteoplasty for severe Slipped Capital Femoral Epiphysis (SCFE). Method. Database from 2006 to 2013 identified 22 patients out of 187 operations for SCFE. 12 underwent Open Neck Osteotomy (ONO) and osteoplasty by Ganz surgical dislocation approach. 10 underwent Arthroscopic Osteoplasty (AO). The mean follow-up for the ONO and AO groups were 59 (46 – 70), 36.1 (33 – 46) months respectively. Results. The unpaired t-test showed that the post-operative corrections were significantly better in the ONO than the AO group. Slip angle (16.7° (1°–28.6°) Vs 47.1° (40.2° – 53.5°) p = .0003), head neck offset correction (5mm (2–13mm) Vs 0mm (0mm – 2mm) p = 0.0003), alpha angle (34.6° (23.2°–45.6°) Vs 61.88° (52.1° – 123°) p= 0.0003), Modified Harris Hip Score (MHHS) (90(86.2–99) Vs 75.5 (58.75 – 96.8) p= 0.003) and internal rotation p= 0.0002. Paired t-test showed significant improvement in corrections within the individual groups compared with their own preoperative values. The results of AO group were oblique plane slip angle (55° (47.7° – 63.2°) Vs 47.1° (40.2° – 53.5°) p= 0.001), alpha angle (90.7° (65° – 131°) Vs 61.88° (52.1° – 123°) p= 0.0001), head neck offset (0mm (−3 mm to 0mm) Vs 0mm (0mm – 2mm) p= 0.001) and MHHS (52.7 (28.7 – 89.1) Vs 75.5 (58.75 – 96.8) p= 0.0005). Complications in ONO group were varus malunion (1) and non-union(1) of the osteotomy. In the arthroscopic group persistent impingement in 3 patients and 5 were not able to return to sports. Conclusion. Our results showed improved hip function following arthroscopic osteoplasty in severe SCFE. Considering the risks of an open surgical dislocation we could find that arthroscopy contributed worthy improvement in hip function in low demand patients

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

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

Purpose: estimate efficiency minimally invasive methods of treatment at patients with tumor lesion of bones. Materials and methods: 145 patients, middle age e 42 years. it has been executed 249 percutaneous vertebroplasty, 15 osteoplasty and 46 radiofrequency thermal ablation Most often minimally invasive methods were carried out to patients with bone metastasis lesion of a breast cancer – 65 (44,8%) and kidneys – 14 (10%) patients. Results: reduction in a painful syndrome on a visual analog scale after operation is noted at 126 (87%) by patients. Positive dynamics Watkins scale at 119 (82%). Improvement of quality of a life on scale Karnofski at 94 (65%) the patient. Complications after vertebroplasty and osteoplasty in the form of methylmethacrylate leak into the surrounding tissues at 19 (18,5%) patients. At one patient after radiofrequency thermal ablation has developed burn skin. There were three pathological bone fractures after radiofrequency thermal ablation. Conclusions: vertebroplasty, osteoplasty and radiofrequency thermal ablation – minimally invasive methods of treatment the patients with tumoral lesion of the bones, allowing in short tim stop a painful syndrome, create adequate stability in a bone segment and improve quality of a life of oncological patients

There is a known association between femoroacetabular impingement (FAI) and osteoarthritis of the hip. What is not known is whether arthroscopic excision of an impingement lesion can significantly improve a patient’s symptoms. This study compares the one-year results of hip arthroscopy for cam-type FAI in two groups of patients. The study (osteoplasty) group comprised 24 patients (24 hips) with cam-type FAI who underwent arthroscopic debridement with excision of their impingement lesion. The control (no osteoplasty) group comprised 47 patients (47 hips) who underwent arthroscopic debridement without excision of their impingement lesion. In both groups, the presence of FAI was confirmed on pre-operative plain radiographs. The modified Harris hip score (MHHS) was used for evaluation pre-operatively and at one year’s follow-up. Non-parametric tests were used for statistical analysis. A tendency towards higher median post-operative MHHS scores was observed in the study than in the control group (83 vs. 77, p = 0.11). This was supported by a significantly higher portion of patients in the osteoplasty group with excellent/good results (83% vs. 60%, p = 0.043). It appears that even further symptomatic improvement may be obtained after hip arthroscopy for FAI by means of the femoral osteoplasty. When treating cam impingement arthroscopically, both central and peripheral compartments of the hip should always be accessed

Introduction and Aims: There is a known association between femoroacetabular impingement (FAI) and osteoarthritis of the hip. What is not known is whether arthroscopic excision of an impingement lesion can significantly improve a patient’s symptoms. Materials and Methods: This study compares the one-year results of hip arthroscopy for cam-type FAI in two groups of patients. The study (osteoplasty) group comprised 24 patients (24 hips) with cam-type FAI who underwent arthroscopic debridement with excision of their impingement lesion. The control (no osteoplasty) group comprised 47 patients (47 hips) who underwent arthroscopic debridement without excision of their impingement lesion. In both groups, the presence of FAI was confirmed on pre-operative plain radiographs. The modified Harris hip score (MHHS) was used for evaluation pre-operatively and at one year’s follow-up. Non-parametric tests were used for statistical analysis. Results: A tendency towards higher median post-operative MHHS scores was observed in the study than in the control group (83 vs. 77, p = 0.11). This was supported by a significantly higher portion of patients in the osteoplasty group with excellent/good results (83% vs. 60%, p = 0.043). Conclusions: It appears that even further symptomatic improvement may be obtained after hip arthroscopy for FAI by means of the femoral osteoplasty. When treating cam impingement arthroscopically, both central and peripheral compartments of the hip should always be accessed

Purpose: The purpose of this work was to demonstrate the usefulness of osteoplasty block for the treatment of primary hip osteochondritis. Material and methods: Eighteen children underwent surgery between 1992 and 2001. Mean age at diagnosis was eight years five months (5–13 years). Preoperatively, mean motion limitation was −25 in abduction and internal rotation. Radiologically the series included: Catterall II Herring B with signs of high-risk head (n=2), III B (n=7), III C (n=1), IV B (n=1), IV C (n=2), and sequelar stage (n=2). Mean excentration was 6.5 mm and mean lateral overhang was 10.2 mm. Surgery was indicated because of an aggravation of the excentration with revascularisation. An iliac graft was encrusted in a limbic rail and covered with rectus femoris tendon left continuous to provide elastic support. A bermuda cast was used for 17 children with immediate weight bearing for eleven. Hospital stay was 36 hours for all children. Results: Sixteen children were reviewed at mean follow-up of three years two months. There were no complications. Clinically, there all patients were pain free, but three developed persistent limping. Ten had a moderate limitation of hip movement and three had severe joint stiffness. Radiologically, there was good head coverage in fifteen hips and joint congruency in fifteen, including eleven with concentric congruency. The intervention was considered useful for twelve children, and not useful for one who developed complete lysis of a poorly positioned graft. Usefulness was uncertain for three children, including the two with a sequelar-stage hip at diagnosis. Discussion: Femoral osteotomy to correct the valgus and pelvic osteotomy to reorient or widen the acetabulum are effective treatments but have many disadvantages (limited abduction movement, leg length discrepancy, re-intervention to remove material). The excellent integration of the plasty block at mid term is a sign of effective head-acetabulum adaptation. Clinical and radiological results have been similar to those obtained with other methods. Joint stiffness and postoperative limping are observed in very severe cases. Joint prognosis depends on the severity of the disease. Conclusion: This series of paediatric patients who have not yet reached bone maturity shows that the plasty block meets expectations for the treatment of early-stage primary hip osteochondritis. Treatment time is short and there are no complications

Introduction: Femoroacetabular Impingement had been until now an unknown pathology. It causes pain in the movements of flexion-adduction-internal rotation, due to a bump effect between the head-neck surface of the femur and the anterior acetabular rim. Material and Method: We analysed our 14 first patients, 3 operated bilaterally with 1 year F.U.. In bilateral cases, the time between both operations ranged from 5 to 8 weeks. Mean Age: 36 years (27 to 48), all sports active patients.. The technique that we used was through our modified Hueter approach . The superoanterior rim of the acetabulum was excised as well as the deformity at the femoral side that causes a less femoral neck-offset. For that purpose we used special maxilofacial-reamers instead of chisels. In this way we avoid any bleeding from the femoral neck. With this technique we avoid a Trochanter osteotomy, as performed by other authors (Ganz, Trousdale) . Results: Pain relief was obtained 4 weeks after surgery in 13 from 14 patients. Mean hospitalization time was 2,6 days (2 to 5). Improvement in ROM was significative (p= 0,006): from −17 mean internal rotation (−14 to −28) at 80 flexion to +23 mean one month postop internal rotation (14 to 32).There was a significant improvement of hip score according to Merle d’Aubigne evaluation (p=0,017): 13,8 points preop (13 to 15) to 16,9 at F.U. (16–18). Neither Trendelemburg nor osteonecrosis was observed in any patient, as possible complications related to the approach. Mean time of rehabilitation was 3,8 weeks ( 3 to 5). All patients returned to their respective sports activities. Discussion: The Modified Femoroacetabular Osteoplasty allows rapid improvement of the normal hip motion , relatively short rehabilitation time and sports resumption as well. However midterm new osteoarthritic changes had to be assessed, although clinical and functional improvement has been evident. This surgical procedure makes us think about other alternatives to hip endoprosthesis in young adults

Purpose

To determine the differences of biomechanical properties in three conditions including 1) native cam deformity 2) cam deformity with incomplete resection and 3) cam deformity with complete resection.

The aim of this study was to determine whether an osteoplasty of the femoral neck performed at the same time as an intertrochanteric Imhäuser osteotomy led to an improved functional outcome or increased morbidity. A total of 20 hips in 19 patients (12 left, 8 right, 13 male, 6 female), who underwent an Imhäuser intertrochanteric osteotomy following a slipped capital femoral epiphysis were assessed over an eight-year period. A total of 13 hips in 13 patients had an osteoplasty of the femoral neck at the same time. The remaining six patients (seven hips) had intertrochanteric osteotomy alone. The mean age was 15.3 years (13 to 20) with a mean follow-up of 57.8 months (15 to 117); 19 of the slips were severe (Southwick grade III) and one was moderate (grade II), with a mean slip angle of 65.3° (50° to 80°); 17 of the slips were stable and three unstable at initial presentation. The mean Non-Arthritic Hip Scores (NAHS) in patients who underwent osteoplasty was 91.7 (76.3 to 100) and the mean NAHS in patients who did not undergo osteoplasty was 76.6 (41.3 to 100) (p = 0.056). Two patients required a subsequent arthroplasty and neither of these patients had an osteoplasty. No hips developed osteonecrosis or chondrolysis, and there was no increase in complications related to the osteoplasty. We recommend that for patients with a slipped upper femoral epiphysis undergoing an intertrochanteric osteotomy, the addition of an osteoplasty of the femoral neck should be considered. Cite this article: Bone Joint J 2014;96-B:1119–23

There is a known association between femoroacetabular impingement and osteoarthritis of the hip. What is not known is whether arthroscopic excision of an impingement lesion can significantly improve a patient’s symptoms. This study compares the results of hip arthroscopy for cam-type femoracetabular impingement in two groups of patients at one year. The study group comprised 24 patients (24 hips) with cam-type femoroacetabular impingement who underwent arthroscopic debridement with excision of their impingement lesion (osteoplasty). The control group comprised 47 patients (47 hips) who had arthroscopic debridement without excision of the impingement lesion. In both groups, the presence of femoroacetabular impingement was confirmed on pre-operative plain radiographs. The modified Harris hip score was used for evaluation pre-operatively and at one-year. Non-parametric tests were used for statistical analysis. A tendency towards a higher median post-operative modified Harris hip score was observed in the study group compared with the control group (83 vs 77, p = 0.11). There was a significantly higher proportion of patients in the osteoplasty group with excellent/good results compared with the controls (83% vs 60%, p = 0.043). Additional symptomatic improvement may be obtained after hip arthroscopy for femoroacetabular impingement by the inclusion of femoral osteoplasty

Slipped capital femoral epiphysis (SCFE) may lead to symptomatic femoroacetabular impingement (FAI). We report our experience of arthroscopic treatment, including osteochondroplasty, for the sequelae of SCFE. . Data were prospectively collected on patients undergoing arthroscopy of the hip for the sequelae of SCFE between March 2007 and February 2013, including demographic data, radiological assessment of the deformity and other factors that may influence outcome, such as the presence of established avascular necrosis. Patients completed the modified Harris hip score (mHHS) and the non-arthritic hip score (NAHS) before and after surgery. . In total, 18 patients with a mean age of 19 years (13 to 42), were included in the study. All patients presented with pain in the hip and mechanical symptoms, and had evidence of FAI (cam or mixed impingement) on plain radiographs. . The patients underwent arthroscopic osteoplasty of the femoral neck. The mean follow-up was 29 months (23 to 56). . The mean mHHS and NAHS scores improved from 56.2 (27.5 to 100.1) and 52.1 (12.5 to 97.5) pre-operatively to 75.1 (33.8 to 96.8, p = 0.01) and 73.6 (18.8 to 100, p = 0.02) at final follow-up, respectively. Linear regression analysis demonstrated a significant association between poorer outcome scores and increased time to surgery following SCFE (p < 0.05 for all parameters except baseline MHHS). Symptomatic FAI following (SCFE) may be addressed using arthroscopic techniques, and should be treated promptly to minimise progressive functional impairment and chondrolabral degeneration. Take home message: Arthroscopy of the hip can be used to treat femoroacetabular impingement successfully following SCFE. However, this should be performed promptly after presentation in order to prevent irreversible progression and poorer clinical outcomes. Cite this article: Bone Joint J 2016;98-B:21–7

The purpose of this study was to elaborate “sparing” surgical treatment of benign tumors and tumorlike lesions of bones in children. Ninety-six experiments on human defrosted tibias and twenty-four operations on chinchilla rabbits showed the effect of co2-laser radiation on osteal structures.the clonation of human bone marrow (one hundred ad nineteen cultures) and seventy-two experiments on chinchilla rabbits revealed the effect of uv-radiation on osteogenesis. The clinical study included five hundred and fifty-seven children with benign tumors and tumorlike lesions of bones. Experimental and clinical investigation showed that co2-laser scanning of residual bone cavity after economic resections prevented relapses of pathological process in 98% cases.osteoplasty with uv-radiated autologus bone marrow in combination with allo-bone material stimulated osteogenesis and provided restoration of bone structure in nine to twelve months. c02-laser operations with simultaneous osteoplasty by uv-radiated autogenous bone-marrow is an effective “sparing” method of surgical treatment of benign tumors and tumorlike lesions of bones in children

Over an eight-month period we prospectively enrolled 122 patients who underwent arthroscopic surgery of the hip for femoroacetabular impingement and met the inclusion criteria for this study. Patients with bilateral hip arthroscopy, avascular necrosis and previous hip surgery were excluded. Ten patients refused to participate leaving 112 in the study. There were 62 women and 50 men. The mean age of the patients was 40.6 yrs (95% confidence interval (CI) 37.7 to 43.5). At arthroscopy, 23 patients underwent osteoplasty only for cam impingement, three underwent rim trimming only for pincer impingement, and 86 underwent both procedures for mixed-type impingement. The mean follow-up was 2.3 years (2.0 to 2.9). The mean modified Harris hip score (HHS) improved from 58 to 84 (mean difference = 24 (95% CI 19 to 28)) and the median patient satisfaction was 9 (1 to 10). Ten patients underwent total hip replacement at a mean of 16 months (8 to 26) after arthroscopy. The predictors of a better outcome were the pre-operative modified HHS (p = 0.018), joint space narrowing ≥ 2 mm (p = 0.005), and repair of labral pathology instead of debridement (p = 0.032). Hip arthroscopy for femoroacetabular impingement, accompanied by suitable rehabilitation, gives a good short-term outcome and high patient satisfaction

Introduction. Femoroacetabular impingement(FAI) is a relatively common cause causes of hip pain and dysfunction in active young adults. The concept of FAI was popularized by Ganz et al in early 2000s. Surgical treatment for FAI has been widely employed over the last two decades. The long term outcome of femoroacetabular osteoplasty (FAO) and risk factors for long-term failure of FAO is less studied. The goal of this single surgeon series is to identify the long term outcome of FAO (minimum 10-year follow-up) and risk factors for surgical treatment failure in these patients. Methods. The prospective database on hip joint preservation identified 1,120 patients who have undergone FAO between January 2005-June 2019. Of these 164 patients (178 hips) have a minimum 10-year follow-up (range, 10–14). The database collects detailed information on patient demographics, clinical history, radiographic and cross sectional imaging findings, intraoperative findings (site and size of chondral lesion, labral tear, subchondral cyst, size of cam lesion, etc), and patient outcome using the modified HHS, SF-36, and UCLA activity score. Patients are contacted on an annual basis and the functional outcome instruments administered. Of 1,120 patients, 122 patients have been lost to follow-up. Results. The mean age of patients in the cohort is 34.3±10.4 years and 39.6% of patients are female. FAO resulted in an improvement in mean mHHS (58.2±3.9 to 86.4±3.2) and SF-36(60.4±4 to 85±4.1) in 89% of patients. At the latest follow up 8.1% of patients have undergone THA. The study found that older age, longer preoperative symptomatic period, higher preoperative alpha angle, presence of hip dysplasia and acetabular retroversion, inability to repair acetabular labrum, and full thickness acetabular chondral lesion were associated with higher risk of failure of treatment. Conclusion. Patients with symptomatic FAI who undergo surgery experience pain relief and functional improvement that appears to endure over a decade in the majority. This study on a large cohort with long term follow-up has also identified patients who are at higher risk of failure. The study has also shed light on some interesting findings such as labral tear being very common in patients without hip symptoms and others that will be presented. For any tables or figures, please contact the authors directly

Purpose: This purpose of this study was to report 2 year outcomes following hip arthroscopy for the treatment of femoroacetabular impingement and chondrolabral dysfunction and determine factors associated with outcomes. Method: Between 3/2005 and 10/2005, 122 patients underwent hip arthroscopy by a single surgeon. Patients were included if they underwent arthroscopic treatment for FAI and chondrolabral dysfunction. All patients were prospectively enrolled in an IRB approved follow-up study. Ten patients refused to participate following enrollment. Results: At arthroscopy, for treatment of impingement, 23 patients underwent only osteoplasty for CAM impingement, 3 patients underwent only rim reduction for pincer impingement and 86 patients underwent osteoplasty and rim reduction for mixed type impingement. Ten patients underwent total hip arthroplasty at an average of 16 months (range: 8–26) after arthroscopy. Average follow-up was obtained on 90%(92/102) at 2.3 years (range: 2.0–2.9). The modified Harris Hip score(MHHS) improved from 57 to 84. HOS ADL improved from 69 to 88. HOS Sport improved from 41 to 69. NAHS improved from 64 to 82. All scores significantly improved (p< 0.05). The average patient satisfaction was 8.4 (range: 1–10). All patients returned to work (15% returned within 1 week, 53% returned in 1–5 weeks, 18% returned in 6–8 weeks, 13% returned in 2 to 6 months). Ten patients underwent THA at an average of 16 months. These patients were significantly older at arthroscopy (58 vs. 39;p=0.0001), had significantly less joint space at all 3 weight bearing surfaces (p=0.001), and patients with microfracture on both femoral head and acetabulum were more likely to undergo THA (p=0.001). The predictors of higher post-operative MHHS were preoperative modified Harris Hip score (p=0.018), joint space of 2mm or greater(p=0.005), and repair of labral pathology instead of debridement (p=0. 032)(r2=0.32;p=0.001). Patients with labral repair had higher MHHS compared to patients with labral debridement (87vs81). Independent predictors of patient satisfaction were postoperative MHHS(p=0.001) and joint space of 2mm or greater(p=0.040) (r2=0.67; p=0.001). Conclusion: Hip arthroscopy for femoroacetabular impingement accompanied by the prescribed rehabilitation led to return to excellent function and high patient satisfaction. Factors associated with higher outcomes included joint space of greater than 2mm, and labral repair for treatment of labral pathology

Aims

Hip arthroscopy has gained prominence as a primary surgical intervention for symptomatic femoroacetabular impingement (FAI). This study aimed to identify radiological features, and their combinations, that predict the outcome of hip arthroscopy for FAI.