Arthroscopic Treatment of Cam Type Femoroacetabular Impingement: Short Term Results

Se-Ang Jang; Young-Ho Cho; Young-Soo Byun; Ki-Hong Park; Han-Sang Kim; Chul Jung

doi:10.5371/hp.2014.26.1.29

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Jang, Cho, Byun, Park, Kim, and Jung: Arthroscopic Treatment of Cam Type Femoroacetabular Impingement: Short Term Results

Original Article

Hip & Pelvis 2014; 26(1): 29-35.

Published online: 31 March 2014

DOI: https://doi.org/10.5371/hp.2014.26.1.29

Arthroscopic Treatment of Cam Type Femoroacetabular Impingement: Short Term Results

Se-Ang Jang, MD, Young-Ho Cho, MD, Young-Soo Byun, MD, PhD, Ki-Hong Park, MD, Han-Sang Kim, MD, Chul Jung, MD

Department of Orthopedic Surgery, Daegu Fatima Hospital, Daegu, Korea.

Address reprint request to Young-Ho Cho, MD. Department of Orthopedic Surgery, Daegu Fatima Hospital, 99 Ayang-ro, Dong-gu, Daegu 701-724, Korea. TEL: +82-53-940-7320, FAX: +82-53-940-7417, femur1973@hanmail.net

Received 17 December 2013 Revised 18 February 2014 Accepted 20 February 2014

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

We evaluated the short term results after treatment of cam type femoroacetabular impingement (FAI) by arthroscopy.

Materials and Methods

We evaluated the clinical and radiological results of arthroscopically treated cam type FAI in patients who had failed conservative treatment with hip pain, with at least 12 months follow-up, from November 2010 to December 2012. There were 19 males and six females. Mean age of patients was 32.9 years (19-57 years) and mean follow up period was 17.2 months (13-31 months). We analyzed the alpha angle, head neck offset, visual analogue scale (VAS), and modified Harris hip score (MHHS).

Results

Mean alpha angle improved from 64.8° to 39.9° and mean head neck offset also improved from 0.8 to 7.6 mm. Peripheral longitudinal and radial fibrillated labral tear was the most common in the anterosuperior quadrant. Damage to acetabular cartilage was identified in 14 patients. Mean VAS improved from 6.3 to 0.9 and mean MHHS improved from 51.7 to 73.6. Complications associated with the operation included three cases of femoral head articular cartilage injury, two cases of pudendal nerve injury, and two cases of lateral femoral cutaneous nerve injury.

Conclusion

Although the short term results for arthroscopically treated cam type FAI were satisfactory, care must be taken to reduce the complications associated with arthroscopy and long term follow is needed in order to determine whether or not it can reduce osteoarthritis of the hip.

Keywords: Cam type, Femoroacetabular impingement, Arthroscopic treatment

Figures and Tables

Fig. 1

Arthroscopic finding shows the labral contusion (arrow head) and peripheral longitudinal tear (arrow) at anterosuperior quadrant of the acetabulum.

Fig. 2

Variable articular cartilage lesions. According to Outerbridge classification, (A) grade 2 partial thickness defect of cartilage (arrow); (B) grade 3 partial thickness defect with diameter more than 1.5 cm (arrow head); and (C) grade 4 full thickness acetabular cartilage defect (asterisk) can be seen.

Fig. 3

Pre-operative anteroposterior (A) and frog leg (B) radiographs of the left hip show asphericity of femoral head and mild pistol-grip deformity and negative head-neck offset and alpha-angle. Alpha angle is shown at B and D. Post-operative anteroposterior (C) and frog leg (D) radiographs show restored sphericity of the femoral head and restored impingement free head-neck offset. The head-neck offset is distance between two parallel lines (B, D).

Fig. 4

Alpha angle is shown at oblique axial view of the femur neck on computed tomogram.

Table 1

Radiographic and Arthroscopic Findings of the Patients

Values are presented as number (%).

Table 2

Pre and Post-operative Radiographic Parameters

Values are presented as mean (range).

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