X Flecher1, J Dumas, J-N Argenson. 1. Center for Ostearthritis Surgery, Musculo-skeletal diseases Institute, Department of Orthopaedic Surgery, Sainte-Marguerite Hospital, 270, boulevard Sainte-Marguerite, BP 29, 13274 Marseille cedex 09, France. xavier.flecher@ap-hm.fr
Abstract
INTRODUCTION: There is increasing interest in using hip arthroscopy for the treatment of femoroacetabular impingement (FAI). However, the distraction is typically done with a traction table, which can lead to complications. Our working hypothesis was that a hip-specific distractor could be used to perform arthroscopic treatment of FAI without the complications associated with traction. MATERIAL AND METHODS: Twenty-three patients were included in this prospective study with an average follow-up of 21 months (range 12-28 months). The average age was 34 ± 4 years. The technical feasibility, complications, quality of the distraction and early clinical results were evaluated. RESULTS: None of the arthroscopy procedures had to be converted to an arthrotomy. In all cases, the procedures planned for the central and peripheral compartments were fully executed. One patient (4%) had a grade 1 cartilage iatrogenic injury of the femoral head. The distraction was determined to be effective in all the patients, with an average of 15 mm of distraction achieved (range 12-21 mm). The average Merle d'Aubigne score went from 11 (range 9-18) preoperatively to 16 (range 14-18) postoperatively; the average Harris score went from 76 (range 46-80) to 91 (range 87-100); the average Christensen score went from 64 (range 48-88) to 84 (range 72-100); the average Womac score went from 58 (range 42-96) to 84 (range 74-100). No neurological, infectious or bone complications were recorded. DISCUSSION: The use of a distractor during hip arthroscopy appears to be a reliable and reproducible technique that allows FAI to be treated. Early results are consistent with those reported in the literature, and the risks associated with the use of a traction table are reduced. This technique makes hip arthroscopy safer and contributes to advances in labrum and cartilage repair, without additional complications. LEVEL OF EVIDENCE: Level III prospective study.
INTRODUCTION: There is increasing interest in using hip arthroscopy for the treatment of femoroacetabular impingement (FAI). However, the distraction is typically done with a traction table, which can lead to complications. Our working hypothesis was that a hip-specific distractor could be used to perform arthroscopic treatment of FAI without the complications associated with traction. MATERIAL AND METHODS: Twenty-three patients were included in this prospective study with an average follow-up of 21 months (range 12-28 months). The average age was 34 ± 4 years. The technical feasibility, complications, quality of the distraction and early clinical results were evaluated. RESULTS: None of the arthroscopy procedures had to be converted to an arthrotomy. In all cases, the procedures planned for the central and peripheral compartments were fully executed. One patient (4%) had a grade 1 cartilage iatrogenic injury of the femoral head. The distraction was determined to be effective in all the patients, with an average of 15 mm of distraction achieved (range 12-21 mm). The average Merle d'Aubigne score went from 11 (range 9-18) preoperatively to 16 (range 14-18) postoperatively; the average Harris score went from 76 (range 46-80) to 91 (range 87-100); the average Christensen score went from 64 (range 48-88) to 84 (range 72-100); the average Womac score went from 58 (range 42-96) to 84 (range 74-100). No neurological, infectious or bone complications were recorded. DISCUSSION: The use of a distractor during hip arthroscopy appears to be a reliable and reproducible technique that allows FAI to be treated. Early results are consistent with those reported in the literature, and the risks associated with the use of a traction table are reduced. This technique makes hip arthroscopy safer and contributes to advances in labrum and cartilage repair, without additional complications. LEVEL OF EVIDENCE: Level III prospective study.
Authors: M Kowalczuk; M Bhandari; F Farrokhyar; I Wong; M Chahal; S Neely; R Gandhi; O R Ayeni Journal: Knee Surg Sports Traumatol Arthrosc Date: 2012-09-02 Impact factor: 4.342
Authors: Ioanna K Bolia; Lorenzo Fagotti; Shannen McNamara; Grant Dornan; Karen K Briggs; Marc J Philippon Journal: J Hip Preserv Surg Date: 2018-08-17