Function and osteoarthritis progression after arthroscopic treatment of femoro-acetabular impingement: A prospective study after a mean follow-up of 4.6 (4.2–5.5) years - 26/09/14
, J.-E. Gédouin b, N. Krantz c, d, O. May c, d, P. Gicquel e, N. Bonin fla
SoFCOTg
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Abstract |
Background |
Outcomes after arthroscopic femoro-acetabular impingement (FAI) surgery are promising in the short-term but have rarely been evaluated in the mid-term (e.g., about 5years). Here, our objectives were to obtain mid-term data on functional and radiographic outcomes, to identify prognostic factors, and to determine the mid-term rate of arthroplasty revision with the associated risk factors.
Hypothesis |
We hypothesized that the results of arthroscopic FAI surgery were sustained over time.
Materials and methods |
We conducted a prospective multi-surgeon study of 53 Tönnis grade 0 or 1 hips treated arthroscopically for symptomatic FAI (23 cam, 10 pincer, and 20 mixed deformities). We obtained short-term (10months) and mid-term (4.6years) data on the functional outcome (WOMAC and satisfaction scores), proportion of patients without revision arthroplasty, and development of osteoarthritis (graded using the Tönnis classification).
Results |
In the patients without revision arthroplasty, the WOMAC score improved significantly (P<0.01) from baseline (61.4±15.6) to 10months (84.2±15.6) and last follow-up (85.2±15.5) but remained unchanged between the two postoperative time points, confirming the stability of the results. The proportion of satisfied patients was 79% after 10months and 68% (36/53) at last follow-up (NS). Osteoarthritis developed in 13/35 (37%) hips for which radiographs were obtained at last follow-up. At last follow-up, 46/53 hips (87%; 95%CI, 78–96) did not required revision surgery; arthroplasty was required in the 7 remaining hips. The main prognostic factor was the preoperative osteoarthritis Tönnis grade: at last follow-up, compared to Tönnis grade 0 hips, Tönnis grade 1 hips had lower WOMAC scores (77 vs. 88), lower satisfaction rates (50% versus 77%), a higher rate of osteoarthritis progression (57% versus 24%), and a higher rate of arthroplasty (33.3% versus 2.9%).
Discussion |
Our results are consistent with published data. The outcomes of arthroscopic FAI surgery are sustained over time and the preoperative osteoarthritis status is the main predictor of mid-term outcomes.
Level of evidence |
IV, prospective cohort study.
Le texte complet de cet article est disponible en PDF.Keywords : Femoro-acetabular impingement, Osteoarthritis, Hip, Labrum, Cartilage
Plan
Vol 100 - N° 6
P. 651-656 - octobre 2014 Retour au numéro
Article précédent
- “Femoroacetabular impingement”. Legg-Calve-Perthes disease: From childhood to adulthood
- F. Accadbled, R. Pailhé, F. Launay, E. Nectoux, N. Bonin, P. Gicquel, SOFCOT f
- Revision of primary total hip arthroplasty for peri-prosthetic fracture: A prospective epidemiological study of 249 consecutive cases in France
- M. Ehlinger, C. Delaunay, M. Karoubi, F. Bonnomet, N. Ramdane, M. Hamadouche, Société française de chirurgie orthopédique et traumatologique (SoFCOT) e
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