Background
Since the modern description of femoroacetabular impingement (FAI) a decade ago, surgical treatment has become increasingly
common. Although the ability of open treatment of FAI to relieve pain and improve function has been demonstrated in a number
of retrospective studies, questions remain regarding predictability of clinical outcome, the factors associated with clinical
failure, and the complications associated with treatment.
Questions/purposes
We therefore described the change in clinical pain and function after open treatment, determined whether failure of treatment
and progression of osteoarthritis was associated with Outerbridge Grade IV hyaline cartilage injury, and described the associated
complications.
Methods
We retrospectively reviewed all 94 patients (96 hips) (55 males and 39 females; mean age, 28 years) who underwent surgical
dislocation for femoroacetabular impingement between 2000 and 2008. Seventy-two of the 96 hips had acetabular articular cartilage
lesions treated with a variety of methods, most commonly resection of damaged hyaline cartilage and labral advancement. Patients
were followed for a minimum of 18 months (mean, 26 months; range, 18–96 months).
Results
Mean Harris hip scores improved from 67 to 91 at final followup. Six of the 96 hips (6%) were converted to arthroplasty or
had worse Harris hip score after surgical recovery. Four of these six had Outerbridge Grade IV acetabular cartilage lesions
and two had Legg-Calvé-Perthes disease or slipped capital epiphysis deformities. Two hips (2%) had refixation of the greater
trochanter.
Conclusions
At short-term followup, open treatment for femoroacetabular impingement in hips without substantial acetabular hyaline cartilage
damage reduced pain and improved function with a low complication rate. Treatment of Outerbridge Grade IV acetabular cartilage
delamination remains the major challenge.
Level of Evidence
Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest,
patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
Each author certifies that his or her institution approved the human protocol for this investigation and that all investigations
were conducted in conformity with ethical principles of research.