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- Title
Is acetabular osteoplasty always required in mixed impingement?
- Authors
Hingsammer, Andreas; Lee, Cara; LaReau, Justin; Kalish, Leslie; Kim, Young-Jo
- Abstract
Background: Mixed femoroacetabular impingement (FAI) is typically managed with both femoral and acetabular rim osteoplasties, but it has not been reported if the rim osteoplasty is always required. Hypothesis/purpose: We hypothesized that mixed FAI managed by femoral or combined femoral and acetabular osteoplasties will both attain satisfactory clinical results, provided intraoperative impingement-free functional motion is attained. Methods: We retrospectively reviewed 30 hips (23 patients, mean age at surgery 24.3 years, mean follow-up time 1.6 years) with mixed FAI who underwent surgical dislocation of the hip and had femoral osteochondroplasty with rim trim (RT, n = 21) or no rim trim (NRT, n = 9). Physical examination results and Western Ontario and McMaster Universities Osteoarthritis (WOMAC) scores were evaluated. Results: Mean (±SD) WOMAC pain scores improved from 6.56 (±2.96) to 2.33 (±3.64) in the NRT group ( p = .002) and from 6.86 (±4.15) to 3.86 (±3.95) in the RT group ( p = .014). Function improved in both groups, but the difference was significant only for the NRT group ( p < .001). Over 50 % of patients in both groups had resolution of impingement sign. Internal rotation increased from 8.6° (±11.8) to 20.0° (±10.4) in the NRT group ( p = .043) and from 4.0° (±12.1) to 18.6° (±14.0) in the RT group ( p < .001). Both groups had increased flexion post-operatively to normal range, but the change was only significant for the RT group ( p = .02). Both groups had insignificant decreases in external rotation. Conclusion: Satisfactory clinical outcomes were seen in hips with mixed impingement, regardless of whether RT was performed, provided impingement-free functional motion was attained and no severe cartilage damage was seen.
- Subjects
ACETABULUM surgery; PAIN; ROTATIONAL motion; STATISTICS; T-test (Statistics); X-rays; DATA analysis; RETROSPECTIVE studies; DESCRIPTIVE statistics; FEMORACETABULAR impingement
- Publication
European Journal of Orthopaedic Surgery & Traumatology, 2015, Vol 25, Issue 2, p331
- ISSN
1633-8065
- Publication type
Article
- DOI
10.1007/s00590-014-1507-z