Femoroacetabular Impingement is a condition in which extra bone grows along one or both bones that form the hip joint — giving the bones an irregular shape. Because they do not fit together perfectly, the bones rub against each other during movement.
To help orthopedic surgeons better understand radiographic parameters associated with successful primary surgery,Philip A. Serbin, MD, Scottish Rite for Children in Dallas, conducted a prospective study to determine pre-operative radiographic parameters that predict reoperation for FAI and, secondarily, correlate radiographic measures and outcomes in these patients.
Dr. Serbin and colleagues enrolled 87 patients under age 19 (average age 16.27 years with 73.6 percent of patients female) who underwent surgery for FAI.
Enrolled patients underwent primary surgery (56 surgical dislocations vs 31 arthroscopes) for FAI. Ten of the patients underwent re-operation (11.5%) at an average of 20.6 months from primary surgery. No differences were found in demographics, activity, surgery type, labral disease, or alpha angle for re-operation vs. non-reoperation.
The Lateral Center-Edge Angle (LCEA), the Femoro-Epiphyseal Acetabular Roof (FEAR) Index, and Sharps angle were significantly different (p<0.05).
Dr. Serbin’s analysis indicated that patients with scores of LCEA<21 and FEAR index>-8.8 were at heightened risk of reoperation. Of the patients with LCEA<21° 46% underwent a reoperation compared to those with LCEA>21° (6%). In patients with FEAR index<-8.8, 32% underwent a reoperation compared to patients>-8.8 (5%). Patients who achieved MCID (61.9%) had lower BMI, worse pre-operative PROs, and better postoperative PROs at 2 years. Alpha and Sharp’s angles were positively correlated with 2+ year PROs, while LCEA was negatively correlated(p<0.05).
Dr. Serbin reported that in patients undergoing treatment for FAI, a reoperation was associated with radiographic signs of hip dysplasia, indicating that patients with a shallower acetabulum are at risk for a repeat operation.
“Surgeons can utilize these parameters to help in surgical decision making, better predict outcomes, and counsel patients about the need for potential subsequent surgery,” Dr. Serbin reported.
The American Orthopaedic Society for Sports Medicine (AOSSM) is the premier global, sports medicine organization representing the interests of orthopaedic surgeons and other professionals who provide comprehensive health services for the care of athletes and active people of all ages and levels. We cultivate evidence-based knowledge, provide extensive educational programming, and promote emerging research that advances the science and practice of sports medicine. AOSSM is also a founding partner of the STOP Sports Injuries campaign to prevent overuse and traumatic injuries in kids.