No abstract

Arthroscopic surgery of the hip is a wellestablished technique with numerous recognized indications. Despite the well-accepted nature of this procedure, there have been no outcomes studies with extended followup. We investigated the response to hip arthroscopy in a consecutive series of patients with 10 years followup. Since 1993, all patients undergoing hip arthroscopy have been assessed prospectively with a modified Harris hip score preoperatively and then postoperatively at 3, 12, 24, 60, and 120 months. A cohort of 50 patients (52 hips) was identified who had achieved 10-year followup and represent the substance of this study. There was 100% followup. The average age of the patients was 38 years (range, 14-84 years), with 27 males and 23 females. The median improvement was 25 points (preoperative, 56 points; postoperative, 81 points). Fourteen patients were converted to THA and two died. Four patients underwent repeat arthroscopy. There were two complications in one patient.

In this series, clinical assessment accurately determined the existence of intra-articular abnormality but was poor at defining its nature. Magnetic resonance arthrography was much more sensitive than magnetic resonance imaging at detecting various lesions but had twice as many false-positive interpretations. Response to an intra-articular injection of anesthetic was a 90% reliable indicator of intra-articular abnormality.

Cam-type femoroacetabular impingement is a recognized cause of intraarticular pathology and secondary osteoarthritis in young adults. Arthroscopy is reportedly useful to treat selected hip abnormalities and has been proposed as a method of correcting underlying impingement. We report the outcomes of arthroscopic management of cam-type femoroacetabular impingement. We prospectively assessed all 200 patients (207 hips) who underwent arthroscopic correction of cam impingement from December 2003 to October 2007, using a modified Harris hip score. The minimum followup was 12 months (mean, 16 months; range, 12-24 months); no patients were lost to followup. The average age was 33 years with 138 men and 62 women. One hundred and fifty-eight patients (163 hips) underwent correction of cam impingement (femoroplasty) alone while 42 patients (44 hips) underwent concomitant correction of pincer impingement. The average increase in Harris hip score was 20 points; 0.5% converted to THA. We had a 1.5% complication rate. The short-term outcomes of arthroscopic treatment of cam-type femoroacetabular impingement are comparable to published reports for open methods with the advantage of a less invasive approach.