Does acetabular dysplasia affect outcome in arthroscopic treatment of cam femoroacetabular impingement? Case-control study with and without acetabular dysplasia - 28/01/19
, Antoine Dangin b, Edouard Ollier c, Nicolas Bonin d
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Abstract |
Background |
Arthroscopic management of femoroacetabular impingement (FAI) is classically contraindicated when acetabular dysplasia is associated, although this is controversial in case of moderate dysplasia or isolated cam effect. A case-control study was therefore conducted comparing borderline (center-edgeangle (CEA), 20–24°), moderate (15–19°) and severe dysplasia (<15°) (group D) versus a control group with normal acetabular cover (CEA, 25–30°). The aims were 1) to determine functional results and satisfaction, and 2) to correlate functional results with severity of dysplasia and of cam effect.
Hypothesis |
Improvement in functional scores and satisfaction is lower in group D than in controls, due to non-correction of dysplasia.
Material and method |
A single-center, single-surgeon retrospective comparative case-control study included all patients with isolated cam-effect FAI and dysplasia but without osteoarthritis (group D) or with isolated cam-effect FAI without dysplasia (controls) operated on during the study period. Cases of mixed impingement were excluded. Preoperative and last-follow-up functional variables included McCarthy's modified Harris Hip Score (mHHS) and Christensen's Non-Arthritic Hip Score (NAHS).
Results |
Between 2011 and 2014, details of 407 patients operated on by arthroscopy were entered in a data-base. Twenty patients (22 hips) were included in group D, with CEA<25° (mean, 19±3.1; range, 10–23°). The control group comprised 23 patients (25 hips) with CEA>25° (mean, 29±2.1°; range, 25–30°) matched for gender, age and body-mass index. Mean follow-up was 29.6±14.1 months (range, 14–58 months) in group D and 31.4±10.6 months (range, 15–57 months) in the control group (p=0.66). For functional scores, the two groups showed respectively 9.9 (−34 to +47) (p=0.038) and 10.4 (−20 to +48) (p=0.0038) gain in mHHS (non-significant: p=0.943). Mean gain in NAHS was 16.6 (−19 to +33) (p=0.0001) and 13.7 (−11 to +47) (p=0.0002), respectively (non-significant: p=0.56)
Conclusion |
Short-term functional results for cam FAI treatment were equivalent with<25° acetabular cover (mean, 19°; range, 13–24°) or normal cover. Longer-term assessment is indispensable to determine the impact of dysplasia and its severity.
Level of evidence |
III, case-control study.
El texto completo de este artículo está disponible en PDF.Keywords : Femoroacetabular impingement, Cam effect, Dysplasia, Borderline dysplasia, Hip arthroscopy
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Vol 105 - N° 1
P. 7-10 - février 2019 Regresar al número
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