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Knee Surg Sports Traumatol Arthrosc. 2017 Jan;25(1):36-44. doi: 10.1007/s00167-015-3794-2. Epub 2015 Sep 19.

Radiographic predictors of femoroacetabular impingement treatment outcomes.

Author information

1
Center for Hip Pain and Preservation, Hospital for Special Surgery, 541 East 71st Street, New York, NY, 10021, USA. ryan.degen@gmail.com.
2
Center for Hip Pain and Preservation, Hospital for Special Surgery, 541 East 71st Street, New York, NY, 10021, USA.
3
Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, USA.

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.

KEYWORDS:

Femoroacetabular impingement; Hip; Radiographic predictors; Systematic review

PMID:
26387126
DOI:
10.1007/s00167-015-3794-2
[Indexed for MEDLINE]

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