Arthroscopic femoral osteochondroplasty for cam lesions with isolated acetabular chondral damage
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Published on: January 23, 2018
1Orthopaedic Surgery Department, Sport Injuries and Arthroscopy Unit, Rabin Medical Center, 39 Jabotinski Street, Petach-Tikva 49100, Israel. barak_haviv69@hotmail.com
Insights
Arthroscopic femoral osteochondroplasty improves hip function for cam lesions, especially with limited chondral damage. Outcomes correlate with acetabular chondral damage severity, with microfracture showing superior results in select cases.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Hip Arthroscopy
Background:
- Femoroacetabular impingement (FAI), specifically cam lesions, is a common cause of hip pain.
- Acetabular chondral damage often coexists with cam lesions, influencing surgical outcomes.
- Arthroscopic femoral osteochondroplasty is a primary treatment for cam impingement.
Purpose of the Study:
- To evaluate the outcomes of arthroscopic femoral osteochondroplasty for cam lesions.
- To assess the impact of acetabular chondral damage severity on surgical results.
- To determine the benefit of microfracture in conjunction with osteochondroplasty for chondral lesions.
Main Methods:
- Retrospective review of 166 patients (170 hips) undergoing arthroscopic femoral osteochondroplasty.
- Patients categorized into three groups based on acetabular chondral damage severity.
- Outcomes assessed using modified Harris Hip Score (MHHS) and Non-Arthritic Hip Score (NAHS).
Main Results:
- Overall improvement in MHHS by 15.3 points and NAHS by 15 points at mean 22-month follow-up.
- Significantly better outcomes observed in hips with less severe acetabular chondral damage.
- Microfracture technique demonstrated superior results in cases with limited chondral lesions.
Conclusions:
- Arthroscopic femoral osteochondroplasty is beneficial for cam impingement, particularly when acetabular chondral damage is minimal.
- The degree of acetabular chondral damage is a critical factor influencing patient outcomes.
- Microfracture augmentation in selected cases with chondral defects enhances surgical benefits.
Abstract:
This study evaluates the outcome of arthroscopic femoral osteochondroplasty for cam lesions of the hip in the absence of additional pathology other than acetabular chondral lesions. We retrospectively reviewed 166 patients (170 hips) who were categorised according to three different grades of chondral damage. The outcome was assessed in each grade using the modified Harris Hip Score (MHHS) and the Non-Arthritic Hip Score (NAHS). Overall, at the last follow-up (mean 22 months, 12 to 72), the mean MHHS had improved by 15.3 points (95% confidence interval (CI), 8.9 to 21.7) and the mean NAHS by 15 points (95% CI, 9.4 to 20.5). Significantly better results were observed in hips with less severe chondral damage. Microfracture in limited chondral lesions showed superior results. Arthroscopic femoral osteochondroplasty for cam impingement with microfracture in selected cases is beneficial. The outcome correlates with the severity of acetabular chondral damage.
