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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 1/2017

01-01-2017 | Hip

Radiographic predictors of femoroacetabular impingement treatment outcomes

Authors: Ryan M. Degen, Danyal H. Nawabi, Asheesh Bedi, Bryan T. Kelly

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 1/2017

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Abstract

Purpose

To review the literature on femoroacetabular impingement (FAI) treatment outcomes, specifically focusing on potential pre-operative radiographic parameters that may provide prognostic information regarding outcomes following surgical management.

Methods

A comprehensive review of computerized literature databases (Medline Ovid and PubMed) was performed, searching for articles reporting on FAI treatment outcomes. A single reviewer screened titles, abstracts and performed full-text reviews of eligible studies. The references of these studies were further screened for additional potentially relevant studies. A total of 243 studies were reviewed, with 18 meeting inclusion criteria.

Results

Thirteen arthroscopic studies reported on 1556 patients, with clinical improvement in 35–92 % of patients and associated failure rates of 12–71 %. Five open surgical studies reported on 238 patients with clinical improvement in 65–95 % of patients and associated failure rates of 0–35 %. Both arthroscopic and open studies identified inferior outcomes with pre-operative radiographic findings of an elevated Tönnis grade (grade 2 or higher), joint space <2 mm, lateral centre-edge angle (LCEA) <20° and incomplete femoral osteoplasty.

Conclusion

Pre-operative radiographic findings of osteoarthritis (Tönnis grade 2/3, <2 mm joint space) or dysplasia (LCEA < 20°) should be considered relative contraindications to joint preservation surgery as outcomes are worse among these patients and associated with a higher risk of conversion to total hip arthroplasty. Care should also be taken to perform a thorough femoral osteoplasty to reduce the risk of failure and need for revision surgery.

Level of evidence

III.
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Metadata
Title
Radiographic predictors of femoroacetabular impingement treatment outcomes
Authors
Ryan M. Degen
Danyal H. Nawabi
Asheesh Bedi
Bryan T. Kelly
Publication date
01-01-2017
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 1/2017
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-015-3794-2

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