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Mini-open approach to FAI treatment improves postoperative patient activity levels
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Investigators determined the mini-open approach for femoroacetabular impingement in patients with hip pain efficient and safe to allow high patient activity levels after surgery, according to recent research.
In 234 patients with femoroacetabular impingement (FAI) who were treated by the mini-open approach, 59 patients were athletes with a preoperative UCLA activity score of 7 or higher and a Super Simple Hip (SUSHI) activity score of 70 or greater. Forty-four of the 59 athletic patients reached the minimum 1-year follow-up during the study period. The mini-direct approach was performed by surgeons through a 4-cm incision and modified Smith-Peterson approach without muscle detachment, according to the abstract.
All patients experienced labral changes, which were classified as tear, detachment or ossification and 84% had chondral lesions. According to the multiple evaluation measures, modified Harris Hip Scores improved from 55 preoperatively to 79 postoperatively and WOMAC scores improved from 47.9 to 8.3. Mean SF-36 scores improved from 65 to 85.
The mean preoperative SUSHI general score was 31.1, compared to the mean postoperative SUSHI general score of 53.6, according to the abstract. Investigators observed minimal change from pre-injury to postoperative UCLA and SUSHI activity scores. Overall, 55% of patients reported a return to their original preoperative sports. The researchers noted that 20% of patients developed meralgia paresthetica after surgery, which resolved within 1 year.
“The mini-open approach for FAO may be a viable alternative to arthroscopy and surgical dislocation in treatment of FAI,” Steven B. Cohen, MD, stated in the study. “Nevertheless, longer term follow-up and randomized trials comparing the treatment modalities for FAI need to be conducted in order to determine the ideal treatment.”
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