Open versus arthroscopic approach in the treatment of femoroacetabular impingement: a case–control study with two-years follow up

Abstract

ObjectiveTo compare clinical and imaging results and complications between patients treated for femoroacetabular impingement (FAI) who underwent either anterior open surgery or an arthroscopic approach, with a minimum follow-up of two years.MethodsThis retrospective case–control study included patients submitted to FAI surgical treatment between November 2007 and March 2012. Patients treated with open surgery were compared with those treated with arthroscopy. Patients were clinically assessed by the modified Harris Hip Score, Non-Arthritic Hip Score, and internal hip rotation. Patients were radiographically assessed by the center-edge angle, joint space width, alpha angle, neck-head index, degree of arthrosis, and presence of heterotopic ossification of the hip.ResultsIn the study period, 56 patients (58 hips) with FAI were included; 16 underwent open surgery and 40 underwent arthroscopy. The 40 patients treated by the arthroscopic route had a mean follow-up of 29.1 months, and 75.6% presented good or excellent clinical results. The radiographic evaluation parameters progressed to normal levels. The 16 patients who underwent open surgery had a mean follow-up of 52 months, and 70.58% presented good or excellent clinical results. The radiographic evaluation parameters progressed to normal levels. Postoperative clinical and radiographic results were considered similar in both groups.ConclusionsArthroscopy and open surgery treatments for FAI provided comparable clinical and radiographic results. However, a higher rate of complications was observed in the open surgery group.

Arthroscopic versus open treatment for femoroacetabular impingement

“…Comparison of postoperative mHHS between AT and OT was conducted among the 3 included studies, [ 14 , 16 , 17 ] which included 124 patients (83 patients receiving AT and 41 patients receiving OT), as shown in Figure 2 . Heterogeneity testing showed that there was low heterogeneity among the studies ( P = .33, I 2 = 9%), so the fixed-effect model was used to pool the data from the 3 studies.…”

“…Comparison of postoperative satisfaction rate between AT and OT was conducted among 2 included studies [ 14 , 16 ] which contain 86 patients in Figure 4 . A heterogeneity test showed that there was no heterogeneity among studies ( P = .71, I 2 = 0%), so the fixed-effect model was used.…”

“…Four included studies [ 14 , 17 – 19 ] including 106 AT group cases and 151 OT group cases provided the data in terms of postoperative alpha angle. A heterogeneity test revealed that no heterogeneity existed among the studies ( P = .75, I 2 = 0%) and the fixed-effect model was used.…”

“…In study by Rego et al, [ 13 ] 11 types of complications were identified in the AT and OT group: 2 adhesive capsulitis cases; delayed consolidation, pseudarthrosis, deep venous thrombosis and superficial wound infection which were only reported after OT; reversible pudendal nerve paresis, perineal cutaneous necrosis, compartment syndrome, hematoma, and heterotopic ossification, which were only reported after AT. For the study by Roos et al, [ 14 ] 1 case (2.43%) presented deep venous thrombosis, 1 case (2.43%) presented heterotopic ossification, and 1 case (2.43%) presented transient paresthesia of the pudendal nerve. There were 2 cases (4.87%) with persistent pain.…”

Evaluation of outcome reporting trends for femoroacetabular impingement syndrome- a systematic review

“…[ 174 ] 2018 III Portugal Retrospective 59 y 198 NAHS 1 56 INCLUDING BOTH Ribas, M. [ 176 ] 2007 IV Spain Retrospective 29.2 y 32 The Merle d’Aubigné -Postel score, WOMAC 2 72 MINI-OPEN TECHNIQUE Riff, A. J. [ 177 ] 2018 IV USA Retrospective 24 y 32 HOS (ADL + SS), mHHS, VAS pain, VAS satisfaction 2 40 ARTHROSCOPIC Rivera, E. [ 178 ] 2020 III Spain Retrospective 24 n 80 iHOT-33, mHHS, VAS pain 2 66 ARTHROSCOPIC Roos, B. D. [ 179 ] 2017 III Brazil Retrospective 36 a n 56 mHHS, NAHS 2 84 INCLUDING BOTH …”