Functional Outcomes of Arthroscopic Treatment in 230 Femoroacetabular Impingement Cases

Abstract

Objective: To analyze the functional outcomes after arthroscopic treatment of femoroacetabular impingement (FAI). Methods: 194 patients (131 males and 63 females), with a mean age of 39 (15-68) years old for men and 43 (16-58) years old for women. The average follow-up was 17 months (2 to 71). 103 patients presented Cam-type FAI, 102 mixed and 25 Pincer. “Unilateral” arthroscopy was performed in 161 cases, “Bilateral” (only once each side) in 46 cases and, “Multiple” (more than one procedure on the same hip) in 23. The female sex was prevalent in the Pincer type FAI (76%), while males were prevalent in Mixed and Cam type, 74.5% and 72.8%, respectively. Results: The mean HHSpre score was 63.7 and 87.1 for HHSpost, i.e. 73.11%. Differences appeared between “mixed” and “unilateral” groups. The complications percentage in this series was 18.7% and 7% progressed to total hip arthroplasty. Conclusion: The arthroscopic FAI treatment improved the postoperative clinical scores of these patients, especially in cases of mixed-type FAI, which presented a higher improvement rate. Insufficient femoral osteoplasty was the main cause for surgical re-intervention, particularly in the initial cases of this series. Level of Evidence II, Retrospective study.

Sex-Based Differences in Prevalence, Outcomes, and Complications of Hip Arthroscopy for Femoroacetabular Impingement: A Systematic Review and Meta-analysis

“…The lack of studies reporting cam incidence by sex limited the cohort to a smaller size, which was made up largely of patients from the study by Salvo et al 77 Therefore, cam prevalence reported here may be less representative of population trends and more reflective of the few studies dominating sex-stratified cam results. However, Laurito et al 46 did find a similar result for cam prevalence, with a higher male prevalence of cam among a cohort of 230 patients with FAIS undergoing HA. Ganz et al 26 stated that cam-type impingement was more common among young men, but that most hips overall showed a mixed-type impingement.…”

“…The significantly higher prevalence of mixed cam/pincer impingement among male patients and pincer impingement among female patients reflected clinical expectations and previously reported trends. 26,46 While sex differences were found for mixed-type and pincer-type FAIS, no significant difference was found for the prevalence of cam-type FAIS. The lack of studies reporting cam incidence by sex limited the cohort to a smaller size, which was made up largely of patients from the study by Salvo et al 77 Therefore, cam prevalence reported here may be less representative of population trends and more reflective of the few studies dominating sex-stratified cam results.…”

“…Retrospective cohort NR 14 200 NR 65 NR 24 Ellenrieder (2017) 21 Case series NR 12 c 30 44.2 38 45.4 3 Flores (2020) 22 Cohort 2 18 59 35.8 72 34.2 24 Frank (2016) 23 Prognostic cohort 2 21 75 37.38 75 38.41 24 Freke (2019) 24 Cross-sectional 3 16 66 NR 48 NR NR Fukushima (2021) 25 Retrospective cohort NR 11 c 5 46.2 0 NR 12 (mean: 40.2) Glein (2021) 28 Cohort 3 21 73 26.4 73 25.6 3, 12, annually Gupta (2016) 30 Case series 4 16 228 NR 367 NR 24 Haynes (2018) 33 Prospective cohort NR 15 254 NR 1321 NR 36 Hetsroni (2013) 34 Retrospective comparative, cross-sectional 45 Case series 4 12 c 810 NR 805 NR 18.7 (mean) Laurito (2021) 46 Retrospective cohort 2 16 131 39 63 43 17 (mean) Lee (2010) 47 Therapeutic case series (retrospective)…”

“… ‖ References 6, 13, 17, 19, 20, 22, 23, 25, 28, 33, 39, 41, 42, 44, 46, 52, 53, 56, 60, 61, 64, 66, 69, 72, 74, 76, 79, 81, 82, 88 –90. …”

What the papers say

“…The authors from Brazil [ 4 ] analysed the functional outcomes after arthroscopic treatment of FAI. A total of 194 patients (131 males and 63 females), with a mean age of 39 and 43 years for males and females, respectively, were included.…”