Anterior femoroacetabular impingement: part II. Midterm results of surgical treatment.

Femoroacetabular impingement has been shown to cause labral and chondral lesions and leads to osteoarthrosis of the hip. With the elimination of the pathogenic cause we hope to prevent or delay additional degeneration of the hip. Fourteen men and five women with a mean age of 36 years (range, 21-52 years) were treated with a surgical dislocation and offset creation of the hip. The followup av- eraged 4.7 years (range, 4-5.2 years). Using the Merle d'Aubignehip score, 13 hips were rated excellent to good, with the pain score im- proving from 2.9 points to 5.1 points at the latest followup. There was no avascular necrosis of the femoral head. Five of the 19 patients, two with Grade 2 osteoarthrosis, two with Grade 1 osteoarthrosis but se- vere acetabular cartilage damage, and one with untreated ossified la- brum had subsequent total hip arthroplasty (THA). In the stable hips without subluxation of the head into the acetabular cartilage defect, no additional joint space narrowing occurred. Surgical dislocation with correction of femoroacetabular impingement yields good results in patients with early degenerative changes not exceeding Grade 1 os- teoarthrosis. This procedure is not suitable for patients with advanced degenerative changes and extensive articular cartilage damage. (Clin Orthop 2004;418:67-73)