Background: Femoroacetabular impingement has been recently described
as a common cause of hip pain and labral tears in young adults. We evaluated
the early clinical results and quality of life after osteochondroplasty of the
femoral head-neck junction for the treatment of femoroacetabular
impingement.
Methods: Thirty-seven hips in thirty-four patients with persistent
hip pain and a mean age of 40.5 years underwent surgical dislocation of the
hip and osteochondroplasty of the femoral head-neck junction for the treatment
of camtype femoroacetabular impingement. All of the patients had had
preoperative evidence of pathological changes in the labrum on imaging. The
clinical course and the quality of life were assessed postoperatively.
Results: The mean score on the Western Ontario and McMaster
Universities Osteoarthritis Index (WOMAC) increased from 61.2 points
preoperatively to 81.4 points at a mean of 3.1 years postoperatively (p <
0.001), the mean University of California at Los Angeles (UCLA) activity score
increased from 4.8 to 7.5 points (p < 0.001), the mean Short Form-12
(SF-12) physical component score increased from 37.3 to 45.6 points (p <
0.001), and the mean SF-12 mental component score increased from 46.4 to 51.2
points (p = 0.031). None of the hips underwent additional reconstructive
surgery. There were no cases of osteonecrosis. Nine patients underwent screw
removal from the greater trochanter because of persistent bursitis. Six of the
thirty-four patients were dissatisfied with the outcome.
Conclusions: Cam-type femoroacetabular impingement is associated
with insufficient concavity at the anterolateral head-neck junction and with
pathological changes in the labrum. Osteochondroplasty of the femoral
head-neck junction following surgical dislocation of the hip joint is safe and
effective and can provide a significant improvement in the overall quality of
life of most patients.
Level of Evidence: Therapeutic Level IV. See Instructions
to Authors for a complete description of levels of evidence.