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Treatment of Femoroacetabular Impingement with a Mini-open Direct Anterior Approach

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Abstract

Background

The opinion about best methods of femoroacetabular impingement (FAI) treatment are not consistent. Operative treatment of this condition may be arthroscopic, but open procedures with osteotomy of the greater trochanter and hip dislocation has been used. The present study evaluates the benefits of the mini-open direct anterior approach (DAA) in treating patients with FAI, with is a procedure available for most orthopedic surgeons.

Materials and Methods

39 patients treated for FAI (25 men and 14 women) at an average age of 29.3 years (range 18-46 years) were reviewed in this retrospective study. The mean followup was 45 months, (range 24-55 months). The hip impingement test was positive in all patients. The diagnosis of FAI was confrmed on anteroposterior and lateral hip view radiographs. All patients were operated with mini-open DAA. The outcomes were assessed with the Harris Hip Score, Short-Form 36 Health Survey and VAS score. Preoperative osteoarthritis was assessed according to Tönnis score.

Results

At the final followup, improvement was noted compared to preoperative status in Harris Hip Score (P < 0.00001), visual analog scale score (P < 0.001), and Short-Form-36 score (P < 0.001). Nineteen patients returned to their previous sports activities. No major complications occurred. One patient developed heterotopic ossifucation and three patients developed temporary postoperative meralgia paresthetica. Five patients from the treatment group required total hip arthroplasty for severe osteoarthritis.

Conclusion

Mini-open DAA is a safe and effective procedure for the treatment of FAI that gives good relief of symptoms and allows a successful return to preoperative activity levels. Further research with a longer followup period is needed to evaluate the influence of surgery on natural history of FAI.

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Authors and Affiliations

  1. Clinic of Orthopaedics and Paediatric Orthopaedics, Medical University of Lodz, Pomorska 251, 92-213, Łodź, Poland

    Marek Synder &  Marcin Sibiński

  2. Department of Angiology, Chair of Anatomy, Medical University of Łódź, Łódź, Poland

    Michał Polguj

  3. Department of Orthopeadic, Postgraduate Medical Education Center, Otwock, Poland

    Dariusz Marczak

  4. Department of Orthopaedics and Traumatology, The Jan Kochanowski University, Grunwaldzka, Kielce, Poland

    Paweł Skowronek

Authors
  1. Paweł Skowronek
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  2. Marek Synder
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  3. Michał Polguj
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  4. Dariusz Marczak
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  5. Marcin Sibiński
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Correspondence to Marcin Sibiński.

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This is an open access artcle distributed under the terms of the Creatve Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creatons are licensed under the identcal terms.

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Skowronek, P., Synder, M., Polguj, M. et al. Treatment of Femoroacetabular Impingement with a Mini-open Direct Anterior Approach. IJOO 51, 677–680 (2017). https://doi.org/10.4103/ortho.IJOrtho_248_16

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  • DOI: https://doi.org/10.4103/ortho.IJOrtho_248_16

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