medigraphic.com
ISSN 2992-8036 (Electronic)
ISSN 2306-4102 (Print)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2009, Number 2

<< Back Next >>

Acta Ortop Mex 2009; 23 (2)

Treatment of femoro-acetabular impingement by a minimally invasive approach. Results at 2 years follow-up

Treviño-Garza Ó, Rivas-Fernández M, Marín-Peña O, Esteban-Ledezma R, Vilarubias-Guillament JM

Language: Spanish
References: 39
Page: 57-69
PDF size: 661.85 Kb.


ABSTRACT

Introduction: Surgical treatment of femoroacetabular impingement (FAI) is becoming a worldwide current practice. In this work we describe our developed minimal-invasive anterior technique as well as the results obtained in our first 117 patients. Material and methods: We evaluated our first 117 operated hips in 115 patients, who underwent to femoroacetabular osteoplasty through minimally invasive anterior approach with a minimal follow up of 2 years. Hips were divided into 3 groups according to radiological Tönnis classification: 32 cases were included in group A (stage 0), 61 cases in group B (stage 1), 24 cases in group C (stage 2). A combined score method (Dexeus Combined Score) was used to compare these groups at 3 months, 6 months and 1 year and each subsequent year. Results: In 30 cases (93.7%) group A, 56 (91.8%) group B and 14 (58.3%) group C satisfactory result was obtained at 6 months, without significant changes over the year (96.8%, 91.8%, 54.1% respectively). After 2 years same behaviour was observed in groups A and B, exception made with group C (96.8%, 93.4%, 45.8% respectively). Differences between groups A and B when compared to group C were statistically significant (p ‹ 0.01). No statistical difference was observed between groups A and B (p › 0.05). Conclusions: Patients improve in their clinical and functional scores. However these results differed in patients with Tönnis stage 0 and 1 when compared to Tönnis 2. Thus, it seems reasonable to recommend to symptomatic patients surgical treatment of FAI as early as it appears.


REFERENCES

  1. Harrison MHM, Schajowicz F, Trueta J: Osteoarthritis of the hip: a study of the nature evolution of the disease. J Bone Joint Surg 1953; 35-B: 598.

  2. Smith-Petersen MN: Treatment of malum coxae senilis, old slipped upper femoral epiphysis, intrapelvic protrusion of the acetabulum and coxa plana by means of acetabuloplasty. J Bone Joint Surg 1936; 18-A: 869-80.

  3. Siebenrock KS, Schoeniger R, Ganz R: Anterior femoro-acetabular impingement due to acetabular retroversion. Treatment with periacetabular osteotomy. J Bone Joint Surg Br 2003; 852: 278-86.

  4. Myers SR, Eijer H, Ganz R: Anterior femoroacetabular impingement after periacetabular osteotomy. Clin Orthop 1999; 363: 93-9.

  5. Beck M, Kalhor M, Leunig M, Ganz R: Hip morphology influences the pattern of damage to the acetabular cartilage: femoroacetabular impingement as a cause of early osteoarthritis of the hip. J Bone Joint Surg 2005; 87(7): 1012–8.

  6. Ganz R, Parvizi J, Beck M, Leunig M, Notzli H, Siebenrock KA: Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res 2003; 417: 112-20.

  7. Ganz R, Gill TJ, Gautier E, Ganz K, Krügel N, Berlemann U: Surgical dislocation of the adult hip: A technique with full access to femoral head and acetabulum without the risk of avascular necrosis. J Bone Joint Surg Br 2001; 83: 1119-24.

  8. Ito K, Minka MA, Leunig M, Werlen S, Ganz R: Femoroacetabular impingement and the cam-effect: A MRI-based quantitative anatomical study of the femoral head-neck offset. J Bone Joint Surg Br 2001; 83: 171-6.

  9. Notzli HP, Wyss TF, Stoecklin CH, Schmid MR, Treiber K, Hodler J: The contour of the femoral head-neck junction as a predictor for the risk of anterior impingement. J Bone Joint Surg Br 2002; 84: 556-60.

  10. Lavigne M, Parvizi J, Beck M, Siebenrock KA, Ganz R: Anterior femoroacetabular impingement. Part I. Techniques of joint preserving surgery. Clin Orthop 2004; 418: 61-6.

  11. Leunig M, Casillas MM, Hamlet M, Hersche O, Notzli H, Slongo T, Ganz R: Slipped capital epiphysis: Early damage to the acetabular cartilage by a prominent femoral metaphysic. Acta Orthop Scan 2000; 71: 370-5.

  12. Leunig M, Podeszwa D, Beck M, Werlen S, Ganz R: Magnetic resonance arthrography of labral disorders in hips with dysplasia and impingement. Clin Orthop 2004; 418: 74-80.

  13. Gosvig KK, Jacobsen S, Palm H, Sonne-Holm S, Magnusson E: A new radiological index for assessing asphericity of the femoral head in cam impingement. J Bone Joint Surg Br 2007; 89(10): 1309-16.

  14. Marin-Peña O, Gebhard C, Velev K, Ribas-Fernandez M, Plasencia-Arriba MA: Femoroacetabular impingement: first step on the way to hip arthroplasty in young patients. J Bone Joint Surg Br Orthop Proc 2006; 88-B: 329.

  15. Reynolds D, Lucas J, Klaue K: Retroversion of the acetabulum: A cause of hip pain. J Bone Joint Surg Br 1999; 81: 281-8.

  16. Harris WH: Etiology of osteoarthritis of the hip. Clin Orthop 1986; 213: 20-33.

  17. Eijer H, Leuning M, Mohamed MN, Ganz R: Cross-table lateral radiograph for screening of anterior femoral head-neck offset in patients with femoro-acetabular impingement. Hip International 2001; 11: 37-41.

  18. Ribas-Fernández M, Marín-Peña O, Ledesma R, Vilarrubias JM: Estudio de los primeros 100 casos mediante abordaje mini-anterior. Rev Ortop Traumatol 2007; 51 Supl 2: 57.

  19. Merle d’Aubigné R, Postel M: Functional results of hip arthroplasty with acrylic prosthesis. J Bone Joint Surg Am 1954; 36: 451-75.

  20. Batlle-Gualda E, Esteve-Vives J, Piera-Riera MC, Hargreaves R, Cutts J: Translation and adaptation to spanish of the WOMAC questionnaire specific for knee and hip osteoarthritis. Rev Esp Reumato 1999; 26(2): 38-45.

  21. Siebenrock KA, Kalbermatten DF, Ganz R: Effect of pelvic inclination on determination of acetabular retroversion. A study on cadaver pelves. Clin Orthop 2003; 407: 241-8.

  22. Beall DP, Sweet CF, Martin HD, et al: Imaging findings of femoroacetabular impingement syndrome. Skeletal Radiol 2005; 34: 691-701.

  23. Kassarjian A: Triad of MRI arthrographic findings in patients with cam-type femoroacetabular impingement. Radiology 2005; 236(2): 588-92.

  24. Beall DP, Sweet CF, Martin HD: Imaging findings of femoroacetabular impingement syndrome. Skeletal Radiol 2005; 34: 691-701.

  25. Marin-Peña O, Ribas-Fernández M, Valles-Purroy A, Gómez-Martín A: Método de valoración intraoperatoria de la resección ósea en el choque femoroacetabular. Rev Ortop Traumatol 2007; 51 Supl 2: 57.

  26. Philippon MJ, Schenker ML: Arthroscopy for the treatment of femoroacetabular impingement in the athlete. Clin Sports Med 2006; 25: 299-308.

  27. Sampson TG: Arthroscopic treatment of femoroacetabular impingement: a proposed technique with clinical experience. Instr Course Lect 2006; 55: 337-46.

  28. Sampson T: Arthroscopic treatment of femoroacetabular impingement. Tech Orthop 2005; 20: 56-62.

  29. Byrd JW: Hip arthroscopy: surgical indications. Arthroscopy 2006; 22(12): 1257-9.

  30. Crawford JR, Villar RN: Current concepts in the management of femoroacetabular impingement. J Bone Joint Surg Br 2005; 87(11): 1459-62. Review.

  31. Murphy S, Tannast M, Kim YJ, Buly R, et al: Debridement of the adult hip for femoroacetabular impingement: indications and preliminary clinical results. Clin Orthop Relat Res 2004; (429): 178-81.

  32. Ribas M, Candioti L, Vilarrubias JM: Tratamiento quirúrgico del síndrome de atrapamiento femoroacetabular anterior de la cadera. J Bone Joint Surg Br Proceedings 2005.

  33. Ribas M, Marín-Peña O, Regenbrecht B, De la Torre B, Vilarrubias JM: Femoroacetabular osteochondroplasty by means of an anterior minimally invasive approach. Hip International, 2007; 2: 91-8.

  34. Ribas M, Regenbrecht B, Vilarrubias JM, Wenda K: Femurazetabuläres impingement: Konzept und chirurgische Behandlung durch ein minimalinvasives Verfahren. Orthopädische Praxis 2006; 42(7): 484-90.

  35. Ribas M, Mercede M, Vilarrubias JM, Sadile F: Impingement femoro-acetabolare: concetto e trattamento con nuova tecnica chirurgica mini-invasiva. Gior Italiano Ortop ed Traum 2006; 32: 168-73.

  36. Parvizi J, Leunig M, Ganz R: Femoroacetabular impingement. J Am Acad Orthop Surg 2007; 15: 561-70.

  37. Clohissy JC, MacClure JT: Treatment of anterior femoroacetabular impingement with combined hip arthroscopy and limited anterior decompression. Iowa Orthop J 2005; 25: 164.

  38. Beaulé PE, Le Duff MJ, Zaragoza E: Quality of life following femoral head-neck osteochondroplasty for femoroacetabular impingement. J Bone Joint Surg Am 2007; 89: 773-9.

  39. Graus E, Sadri H, Menetrey J, Hoffmeyer P: Therapie des femoroazetabulären Impingements: Artroskopische Technik versus Chirurgische Luxation. Vortrag Nr. 52 bei der 56. Jahrestagung der Vereinigung Süddeutscher Orthopäden. e.V. 1 bis 4 Mai 2008 in Baden – Baden. Aceptado para su publicación en JBJS-Br.




2020     |     www.medigraphic.com