Quantitative evaluation of residual bony impingement lesions after arthroscopic treatment for isolated pincer-type femoroacetabular impingement using three-dimensional CT

Zhuo, Hongwu; Wang, Xuesong; Liu, Xin; Song, Gonghua; Li, Yue; Feng, Hao

doi:10.1007/s00402-015-2245-3

Cited by 14 publications

(8 citation statements)

References 25 publications

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“…These have consisted of localized débridement or removal of the anterior acetabular rim via either open or arthroscopic techniques [29,30,33,34,43,57] or by reorientation of the entire acetabulum by periacetabular osteotomy (PAO) resulting in anteversion [31,39,40]. At shortterm followup (defined as 2-4 years), both surgical treatments have demonstrated substantial improvements in clinical scores without radiographic progression of osteoarthritis [29-31, 33, 34, 39, 40, 43].…”

Section: Introductionmentioning

confidence: 99%

Periacetabular Osteotomy Provides Higher Survivorship Than Rim Trimming for Acetabular Retroversion

Zurmühle

Anwander

Albers

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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Background Acetabular retroversion can cause impaction-type femoroacetabular impingement leading to hip pain and osteoarthritis. It can be treated by anteverting periacetabular osteotomy (PAO) or acetabular rim trimming with refixation of the labrum. There is increasing evidence that acetabular retroversion is a rotational abnormality of the entire hemipelvis and not a focal overgrowth of the anterior acetabular wall, which favors an anteverting PAO. However, it is unknown if this larger procedure would be beneficial in terms of survivorship and Merle d'Aubigné scores in a midterm followup compared with rim trimming. Questions/purposes We asked if anteverting PAO results in increased survivorship of the hip compared with rim trimming through a surgical hip dislocation in patients with symptomatic acetabular retroversion. Methods We performed a retrospective, comparative study evaluating the midterm survivorship of two matched patient groups with symptomatic acetabular retroversion undergoing either anteverting PAO or acetabular rim trimming through a surgical hip dislocation. Acetabular retroversion was defined by a concomitantly present positive crossover, posterior wall, and ischial spine sign. A total of 279 hips underwent a surgical intervention for acetabular retroversion at our center between 1997 and 2012 (166 periacetabular osteotomies, 113 rim trimmings through surgical hip dislocation). A total of 99 patients (60%) were excluded from the PAO group and 56 patients (50%) from the rim trimming group because they had any of several prespecified conditions (eg, dysplasia . A minimum followup of 2 years was required for this study. Failures were included at any time. The median followup for the anteverting PAO group was 9.5 years (range, 2-17.4 years) and 6.8 years (range, 2.2-10.5 years) for the rim trimming group (p \ 0.001). Kaplan-Meier survivorship analysis was performed using the following endpoints at 5 and 10 years: THA, radiographic One author (MT) has received funding from the Swiss National Science Foundation (SNSF). All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are on file with the publication and can be viewed on request. Each author certifies that his or her institution has approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

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Section: Introductionmentioning

confidence: 99%

Periacetabular Osteotomy Provides Higher Survivorship Than Rim Trimming for Acetabular Retroversion

Zurmühle

Anwander

Albers

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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“…In patients with worse results after hip arthroscopy, residual intraarticular FAI could be detected as a possible cause for failure [20]. But also extraarticular AIIS hypertrophy could be detected in 49% of the patients undergoing revision hip arthroscopy and a complete correction of AIIS impingement was a significant predictor for a better result after revision hip arthroscopy [12].…”

Section: Discussionmentioning

confidence: 99%

Is the evaluation of the anterior inferior iliac spine (AIIS) in the AP pelvis possible? Analysis of conventional X-rays and 3D-CT reconstructions

Krueger

Windler

Geßlein

et al. 2017

Arch Orthop Trauma Surg

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“…1), also known as residual or unaddressed cam-type, pincer-type, or a mixed-type FAI configuration, is the most frequent explanation for failed hip surgery and the most common indication for revision surgery within the first 2 years after index FAI surgery. 5,[13][14][15][16][17][18] Open surgical dislocation of the hip enables a good visualization of the joint, 360-degree access to the joint, surgical treatment of various impingement pathologies, and restoration of a precise sphericity of the femoral head-neck junction using templates. 19 Thus open surgical dislocation of the hip was originally considered the gold standard in FAI treatment.…”

Section: Undercorrectionmentioning

confidence: 99%

Postoperative Imaging after Impingement Surgery

Dietrich

Grob

Kim

2017

Semin Musculoskelet Radiol

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In addition to the patient's medical history and clinical evaluation, conventional radiographs and magnetic resonance imaging (MRI) are important tools to indicate appropriate conservative treatment or even revision surgery in patients with symptoms after surgical management of femoroacetabular impingement (FAI). We present an overview of current evidence in postoperative imaging after impingement surgery. Undercorrection of the underlying osseous FAI configuration is the most frequent indication for revision surgery within the first 2 years after index FAI surgery. Femoral neck fractures, iatrogenic chondral injuries, early conversion to total hip arthroplasty, loose bodies, and heterotopic ossifications are rare but typical early complications after surgical treatment of FAI. Abnormal MRI findings after FAI surgery such as intra-articular adhesions, labral tears, cartilage defects, and anterior capsular defects are common findings in both asymptomatic and symptomatic postoperative patients. Avascular necrosis of the femoral head is an extremely rare complication after surgical treatment of FAI.

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Quantitative evaluation of residual bony impingement lesions after arthroscopic treatment for isolated pincer-type femoroacetabular impingement using three-dimensional CT

Cited by 14 publications

References 25 publications

Periacetabular Osteotomy Provides Higher Survivorship Than Rim Trimming for Acetabular Retroversion

Periacetabular Osteotomy Provides Higher Survivorship Than Rim Trimming for Acetabular Retroversion

Is the evaluation of the anterior inferior iliac spine (AIIS) in the AP pelvis possible? Analysis of conventional X-rays and 3D-CT reconstructions

Postoperative Imaging after Impingement Surgery

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