Arthroscopic technique successful at treating femoro-acetabular impingement in elite athletes

All patients returned to their sport by 14 weeks, regardless of their age or event.

MANCHESTER, England — High-level athletes treated by arthroscopic femoral osteochondroplasty and acetabular rim resection, when indicated, returned to the practice field in just over 3 months, reported an orthopedic surgeon from Coventry, England.

In a series of 12 professional or competitive amateur athletes treated consecutively in 2006 at Warwick Medical School, University Hospital of Coventry, eight patients presented with mechanical or exercise-induced hip symptoms and cam-type femoro-acetabular impingement. Four athletes had a mixed cam- and pincer-type impingement, noted Damian Griffin, FRCS, who presented his findings at the British Orthopaedic Association Annual Congress 2007.

The mean operative time for the arthroscopic procedure was 140 minutes (range, 100 to 215 minutes). All but one patient was discharged the day after surgery, he said.

The researchers followed the patients using the Non-Arthritic Hip Score (NAHS). There were two complications, including one involving a surgeon error that required a revision.

Griffin said the most difficult part of the surgery is "... knowing where you are as you manipulate the tissue."

All patients were asked to be partially weight-bearing with crutches for 4 weeks, and most patients returned to training within 6 weeks. All of the athletes returned to active training and/or competition by 14 weeks.

Symptoms improved in all patients, with mean NAHS results progressing from 71 preoperatively to 93 at 6 months.

"We also saw that there was no joint space loss in any of the patients," he said.

Griffin said he was pleased with the early outcomes of the procedure with elite athletes, who, as a group, sometimes delay seeking orthopedic care for such hip injuries.

Audience members commended the study and suggested that these problems may be more common in athletes than once thought, particularly among young soccer players, who often place added stress on the hip via various kicking motions.

For more information:
Griffin D, Karthikeyan S. Treatment of femoro-acetabular impingement in elite athletes: arthroscopic surgical technique and early results. Presented at the British Orthopaedic Association Annual Congress 2007. Sept. 25-28, 2007. Manchester, England.