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Treatment of FAI with open dislocation, mini-open, arthroscopic methods found satisfactory
Matsuda DK, et al. Arthroscopy. doi: 10.1016/j.arthro.2010.09.011
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Open dislocation, mini-open, and arthroscopic methods for the treatment of symptomatic femoracetabular impingement all have been found safe and effective in the improvement of pain and function over short-term to mid-term studies, according to a recent study.
Comparatively, the authors noted, “the historical gold standard of open dislocation surgery had a … high major complication rate primarily because of trochanteric osteotomy-related issues.”
To compare methods, the researchers sent 13 relevant queries in four search engines with a result of 5,856 articles. Inclusion criteria included a minimum 1-year follow-up of surgical treatment of skeletal pathoanatomy, as well as associated chondrolabral pathology in skeletally mature patients with femoroacetabular impingement. In all, the authors reported, 18 peer-reviewed outcome studies met those needs.
The authors reported the studies included 6 open surgical dislocation, 4 mini-open, and 8 arthroscopic — all with levels of evidence of III or IV. Arthroscopic studies were the only prospective studies performed. Once all data was collected, the team extracted outcome data and analyzed it for surgical efficacy, failure rates and complications.
Efficacy for the mini-open method was comparable to open dislocation surgery, but also demonstrated “a significant incidence of iatrogenic injury to the lateral femoral cutaneous nerve in some studies.”
“The arthroscopic method had surgical outcomes equal to or better than the other methods, with a lower rate of major complications when performed by experience surgeons,” the authors wrote.