Arthroscopic treatment of femoroacetabular impingement of the hip: A new technique to access the joint

Abstract

Femoroacetabular impingement has been established as an important cause of groin pain and limitation of range of motion in young, active patients and a possible cause for early osteoarthritis of the hip. Open surgery is a well-recognized approach for treatment and probably the standard for most surgeons, but recent reports regarding arthroscopic treatment procedures suggest comparable results. We present a technique that provides a way to securely penetrate the joint capsule and evaluate the clinical results of this technique in patients with femoroacetabular impingement. Between 2004 and 2007, we prospectively followed a cohort of 105 hips (88 patients; 60 males, 28 females) who underwent surgery for symptomatic cam or mixed femoroacetabular impingement. All patients were evaluated for the Nonarthritic Hip Score, clinical parameters, visual analog scale pain score, initial radiographic degenerative changes, and alpha angle. At a minimum followup of 1.3 years (average, 2.3 years; range, 1.3-4.1 years), all clinical outcome measures improved. The Nonarthritic Hip Score improved from 56.7 points (range, 15-92.5 points) to 84.6 points (range, 47.5-100 points). Nine patients (8.6%) underwent THA during followup. The outcome measures after arthroscopic therapy for femoroacetabular impingement seem comparable to those reported after open procedures. Level of Evidence: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence. © 2009 The Association of Bone and Joint Surgeons®.