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Does arthroscopic FAI correction improve function with radiographic arthritis?

Christopher M Larson¹, M Russell Giveans, Mehul Taylor

¹Minnesota Orthopedic Sports Medicine Institute, 4010 West 65th Street, Edina, MN 55435, USA. chrislarson@tcomn.com

Clinical Orthopaedics and Related Research

|December 25, 2010

Summary

Hip arthroscopy for femoroacetabular impingement (FAI) improves pain and function in patients with mild joint space narrowing. Advanced narrowing predicts poor outcomes, suggesting these patients should not undergo arthroscopic FAI correction.

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Area of Science:

Orthopedic surgery
Hip joint biomechanics
Osteoarthritis research

Background:

Previous studies on hip arthroscopy outcomes for femoroacetabular impingement (FAI) often did not account for pre-existing osteoarthritis.
The impact of preoperative joint space narrowing on FAI treatment is not well-defined.

Purpose of the Study:

To evaluate functional improvements after FAI resection in patients with preoperative joint space narrowing.
To identify predictors of pain, function, and failure rates following FAI surgery.

Main Methods:

A cohort of 210 patients (227 hips) with FAI and minimum 12-month follow-up were analyzed.
Patients were divided into two groups: FAI (no joint space narrowing) and FAI-OA (with joint space narrowing).
Harris hip scores, SF-12, and VAS pain scores were collected pre- and post-operatively.

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Main Results:

Patients without joint space narrowing (Group FAI) showed better functional and pain score improvements compared to those with narrowing (Group FAI-OA).
The FAI-OA group had a significantly higher failure rate (52%) versus the FAI group (12%).
Advanced joint space narrowing, higher MRI chondral grade, and longer symptom duration predicted poorer outcomes.

Conclusions:

Arthroscopic FAI correction yields positive outcomes for patients with mild preoperative joint space narrowing.
Patients presenting with advanced radiographic joint space narrowing demonstrate no improvement and are not candidates for arthroscopic FAI correction.