Is Only Peripheral Hip Arthroscopy Enough for Selected Patients with Femoroacetabular Impingement Syndrome?

Ibrahim Tuncay; Vahdet Ucan; Muzaffer Agir; Wasim Anwar; Nurzat Elmali

doi:10.22038/ABJS.2022.53954.2698

Is Only Peripheral Hip Arthroscopy Enough for Selected Patients with Femoroacetabular Impingement Syndrome?

Arch Bone Jt Surg. 2022 Dec;10(12):1044-1048. doi: 10.22038/ABJS.2022.53954.2698.

Authors

Ibrahim Tuncay¹, Vahdet Ucan¹, Muzaffer Agir¹, Wasim Anwar², Nurzat Elmali¹

Affiliations

¹ Department of Orthopedics and Traumatology, Bezmialem Foundation University School of Medicine, Istanbul, Turkey.
² Department of Orthopedics and Spine Surgery, Medical Teaching Institue, Hayatabad Medical Complex Pashawar, Pakistann.

Abstract

Background: Peripheral compartment hip arthroscopy has gained popularity over central compartment hip arthroscopy as peripheral compartment arthroscopy does not cause perineal post compression, prolonged lower extremity traction and thus complications such as acetabular labrum and articular cartilage injuries. The study, in essence, aims to emphasize that peripheral hip arthroscopy (OPHA) alone is sufficient without an additional surgical method in the treatment of femoroacetabular impingement syndrome (FAI).

Methods: A total of 35 patients, being 21 female and 14 male, among a group of patients who were suffering from FAI syndrome and applied to private hip conservatory centers and has undergone hip arthroscopy at a later stage by a senior surgeon (I.T.) were selected from the medical-based software of the hospital. Patients with intra-articular pathology as a result of magnetic resonance imaging (MRI) were excluded from the study. The group had a mean age of 40.6, youngest being 17 and oldest 69, while the mean observation period was 26.6 months, varying between shortest 6 months and longest 63. In order to assess the patient satisfaction as well as clinical outcomes, Postel Merle d'Aubigné (PMA) score was used.

Results: When patient satisfaction was evaluated, overall decrease in pain was found and when gait characteristics were evaluated together with movement, an increase in overall satisfaction was found (P<0.05). Secondary arthroscopic procedures was not required in any of the patients included in this study. A group of three patients only needed some additional surgical interventions like stem cell therapy, hip arthroplasty and pelvic osteotomy.

Conclusion: OPHA can provide adequate treatment in selected FAI patients as it allows us to avoid critical complications such as damage to the cartilage, avascular necrosis, complications caused by traction and prolonged operation times seen in central compartment arthroscopy.

Keywords: Femoroacetabular impingement syndrome; Hip arthroscopy; Peripheral compartment.