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Arthroscopy. 2017 Apr;33(4):773-779. doi: 10.1016/j.arthro.2016.10.022. Epub 2017 Jan 4.

Isolated Acetabuloplasty and Labral Repair for Combined-Type Femoroacetabular Impingement: Are We Doing Too Much?

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Northwestern University, Feinberg School of Medicine, Chicago, Illinois, U.S.A.. Electronic address:
Northwestern University, Feinberg School of Medicine, Chicago, Illinois, U.S.A.



To evaluate patient outcomes after isolated arthroscopic volumetric acetabular osteoplasty and labral repair for the treatment of patients with combined femoroacetabular impingement (FAI) lesions.


A review of a prospectively collected registry identified 86 patients (106 hips) with an average age of 38.1 years (range, 17-59 years) with combined-type FAI that underwent isolated acetabular osteoplasty and labral repair. Preoperative α-angle, degree of radiographic degenerative changes, and presence of a crossover sign were recorded. Clinical outcomes were assessed with the modified Harris Hip Score (mHHS), International Hip Outcome Tool-12 (iHOT-12), Hip Outcome Score Sport-Specific Subscale (HOS-SSS), and patient satisfaction score (out of 10) at a minimum 2-year follow-up.


Clinical follow-up was obtained at a mean follow-up of 37.2 months (range, 27.9-79.2 months). Patients with Tönnis grade 0 and I findings had significantly higher mHHS (83.5 vs 71.5, P = .01), HOS-SSS (81.3 vs 59.9, P = .02), and iHOT-12 scores (71.1 vs 58.8, P = .04) compared to patients with Tonnis grade II changes. However, patient satisfaction scores (8.0 vs 7.2, P = .45) were no different. No significant difference was noted between unilateral and bilateral hip patient outcome scores. Patient age and preoperative α-angles did not correlate with any outcome scores (all R2 <0.05). There were no cases of revision surgery or progression to arthroplasty.


Isolated acetabular decompression may adequately address the underlying impingement in combined-type FAI while avoiding the risks associated with femoral-sided decompression. Good to excellent patient-reported outcomes and satisfaction scores were noted with significantly higher scores in patients with minimal arthritic change. Patient age and preoperative α-angle had less effect on postoperative outcomes.


Level IV, therapeutic case series.

[Indexed for MEDLINE]

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