Mini-Open Approach for Femoroacetabular Impingement: 10 Years Experience and Evolved Indications

Bellotti, Vittorio; Cardenas, Carlomagno; Astarita, Emanuele; Moya, Esther; Meo, Federico De; Ezechieli, Marco

doi:10.5301/hipint.5000408

Cited by 13 publications

(13 citation statements)

References 40 publications

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“…The risk factors of failure in the treatment of FAI were investigated in many studies [14, 18, 19, 21, 29]. Our results were comparable to those reported in other literature, showing that younger patients and patients in the early stages of hip osteoarthritis (Tönnis 0 or Tönnis I) might benefit from surgical treatments [9, 19]. Boone et al supposed that caution should be taken to perform surgical dislocation in patients over the age of 40 [30]; in our series using minimally invasive approach, patients younger than 55 still gained benefit from the surgery.…”

Section: Discussionsupporting

confidence: 85%

“…Several studies have reported the results of using mini-open technique in the treatment of FAI [8, 9, 19]. Most of the authors used anterior Hueter approach on an extension table or fracture table, taking the advantage of intermuscular and internervous dissection [18].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the hip arthroscopy may result in inadequate resection of bony deformities, especially in complex cases or in the early stage of learning curve [16, 17, 34]. The most distal and posterior head-neck junction lesions are often underrated in particular [9]. In this respect, mini-open arthrotomy provides direct vision to the pathomorphologies of the femoral heads and avoids excessive traction during the surgeries.…”

Section: Discussionmentioning

confidence: 99%

“…The aims of surgery for FAI are to correct bony deformities and address associated labral or chondral lesions [8]. Three main surgical approaches currently being used are open surgical dislocation, hip arthroscopy, and minimally invasive open surgery, each with their advantages and disadvantages [9–11]. Although surgical hip dislocation and open osteochondroplasty has satisfactory clinical results and been considered the gold-standard procedure, complication rates related to intraarticular adhesion and trochanteric osteotomy were not uncommon [12, 13].…”

Section: Introductionmentioning

confidence: 99%

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Treatment of cam-type femoroacetabular impingement using anterolateral mini-open and arthroscopic osteochondroplasty

Mahameed

Lin

et al. 2019

J Orthop Surg Res

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Background Femoroacetabular impingement (FAI) is associated with decreased hip function and early hip osteoarthritis. Surgical treatment is often required to halt the process of mechanical degeneration. The study investigated the short-to-midterm results of using a modified anterolateral mini-open and arthroscopic osteochondroplasty in the treatment of cam-type FAI. Methods Thirty-six patients (39 hips), with the mean age of 43.6 years, who had cam-type FAI, were operated by a mini-open and arthroscopy-assisted osteochondroplasty via the Watson-Jones interval between 2002 and 2016. Radiographic parameters and Harris hip scores were retrospectively analyzed after a mean follow-up of 44 months. Results Of the 39 hips, the mean Harris hip score significantly improved from 61.1 preoperatively to 84.2 postoperatively ( P < 0.01). There were nine hips (23%) undergoing total hip arthroplasty (THA) at a mean of 22 months (range, 3~64 months) due to progression of hip osteoarthritis. The 5-year survival for hip preserving was 74.9%. Cox proportional-hazards model showed that age ≥ 55 years ( P = 0.03) and preoperative Tönnis stage II ( P = 0.02) were independent risk factors for conversion to THA. Conclusions The mini-open and arthroscopic approach allowed direct visualization and improved quality of the osteochondroplasty of FAI hip while avoiding the need for surgical dislocation. This technique could be a safe and viable option for symptomatic cam-type FAI patients to relieve symptoms and improve hip function.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Treatment of cam-type femoroacetabular impingement using anterolateral mini-open and arthroscopic osteochondroplasty

Mahameed

Lin

et al. 2019

J Orthop Surg Res

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“…Several studies have reported good results in the management of patients with FAI using an anterior Hueter approach. 5 , 20 , 29 , 30 However, the anterior Hueter approach might make it difficult to access the subspine space. Cohen et al 7 managed FAI in athletes using a direct mini-open approach and demonstrated significant improvement in functional outcomes.…”

Section: Discussionmentioning

confidence: 99%

Outcomes After Management of Subspine and Femoroacetabular Impingement Using a Direct Anterior Mini-Open Approach

Chen

Peng

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: Subspine impingement (SSI) has been commonly managed with arthroscopic decompression. However, arthroscopic decompression is a demanding technique, as under- or over-resection of the anterior inferior iliac spine (AIIS) could lead to inferior outcomes. An anterior mini-open approach has also been used in the management of femoroacetabular impingement (FAI), and it could provide adequate visualization of the anterior hip joint without a long learning curve. Purpose/Hypothesis: The objective of the current study was to compare the outcomes of SSI patients with FAI who underwent arthroscopic subspine decompression and osteoplasty with a group undergoing subspine decompression and osteoplasty using a modified direct anterior mini-open approach. It was hypothesized that there would be no significant difference in outcomes between the groups. Study Design: Cohort study; Level of evidence, 3. Methods: We reviewed the records of SSI patients who underwent decompression surgery (arthroscopic or mini-open) at our institution from June 1, 2015 to December 31, 2016. Both groups underwent the same postoperative rehabilitation protocol. Preoperative and 2-year postoperative patient-reported outcomes were compared using the modified Harris Hip Score (mHHS), International Hip Outcome Tool–33 (iHOT–33), and Hip Outcome Score—Activities of Daily Living (HOS–ADL). Major and minor complications as well as reoperation rates were recorded. Results: Included were 47 patients (49 hips) who underwent subspine decompression using an anterior mini-open approach and 35 patients (35 hips) who underwent arthroscopic subspine decompression. There were no differences in demographic and radiological parameters between the groups, and patients in both groups showed significant improvement in all outcome scores at follow-up. The pre- to postoperative improvement in outcome scores was also similar between groups (mini-open vs arthroscopy: mHHS, 26.30 vs 27.04 [ P = .783]; iHOT–33, 35.76 vs 31.77 [ P = .064]; HOS–ADL, 26.09 vs 22.77 [ P = .146]). In the mini-open group, 10 of the 47 patients had temporary meralgia paresthetica, and fat liquefaction was found in 1 female patient. There were no reoperations in the mini-open group. Conclusion: Subspine decompression using the anterior mini-open approach had similar outcomes to arthroscopic decompression in the management of SSI. The lateral femoral cutaneous nerve should be protected carefully during use of the anterior mini-open approach.

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Mini-Open Approach to the Hip

Yacovelli¹,

Chen²,

O’Toole³

et al. 2021

Hip Arthroscopy and Hip Joint Preservation Surgery

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Mini-Open Approach for Femoroacetabular Impingement: 10 Years Experience and Evolved Indications

Cited by 13 publications

References 40 publications

Treatment of cam-type femoroacetabular impingement using anterolateral mini-open and arthroscopic osteochondroplasty

Treatment of cam-type femoroacetabular impingement using anterolateral mini-open and arthroscopic osteochondroplasty

Outcomes After Management of Subspine and Femoroacetabular Impingement Using a Direct Anterior Mini-Open Approach

Mini-Open Approach to the Hip

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