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Patients with femoroacetabular impingement may benefit from hip arthroscopy

Issue: February 2012

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Dean K. Matsuda

WAILEA, Hawaii – Speakers at Orthopedics Today Hawaii 2012 meeting debated the use of arthroscopy to treat femoroacetabular impingement.

Dean K. Matsuda, MD, said that systematic reviews of arthroscopic surgery performed by experienced surgeons for femoroacetabular impingement (FAI) have shown outcomes that are at least as good, if not better, than open and mini-open methods with a lower rate of major complications. Patients also have accelerated rehabilitation because it is an outpatient procedure, and patients return to cycling and ambulation earlier. The procedure also permits high flexion, earlier abductor strengthening and return to sport, he said.

“Is an arthroscope all you need for FAI? From a literal standpoint, obviously no. You need a good burr, good instrumentation and you need experience. There will always be an exception to the rule,” Matsuda said. “But, from a practical standpoint, yes. The arthroscopic method allows for an outpatient procedure, better outcomes, less danger of complications, quicker rehab, better cosmesis and the option for a simultaneous bilateral surgery should you choose to do that.”

In his presentation, Robert T. Trousdale, MD, said that he favors open surgery for the treatment of FAI when major structural problems present. Open dislocation and debridement is safe, he said. The procedure carries no risk for avascular necrosis, trochanteric problems are rare and it can handle all pathology.

“I do think the future is for less invasive technology,” he said.

References:

• Matsuda DK. An arthroscope is all you need for FAI. Trousdale RT. Open surgical hip dislocation for impingement. Both presented at Orthopedics Today Hawaii 2012, Jan. 15-18. Wailea, Hawaii.
• Disclosures: Matsuda receives royalties from Smith & Nephew and the receipt of intellectual property rights/patent holder for ArthroCare and Smith & Nephew. Trousdale has relationships with DePuy, Wright Medical, Mako and Mayo Clinical.

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