New Private Hospitals Group, 3, rue Eric-Tabarly, 44277 Nantes cedex 2, France.
Orthop Traumatol Surg Res. 2010 May;96(3):222-7. doi: 10.1016/j.otsr.2009.12.002. Epub 2010 Apr 10.
Arthroscopic treatment of femoroacetabular impingement (FAI) is recommended since it is a minimally invasive procedure allowing full access to the hip joint.
Arthroscopic treatment can alleviate FAI without use of a perineal support.
To describe an early experience of hip arthroscopy in the treatment of FAI using two types of hip distraction without perineal support; to assess morbidity of FAI release under arthroscopic control and its early clinical and radiological outcome.
In the first 32 cases, the procedure used an invasive distractor and started with the central compartment. In the last six cases, it started with the peripheral compartment using a dedicated traction table with a contralateral buttock support. Inclusion criteria were: positive impingement test and radiological evidence of FAI. Thirty-eight consecutive patients with mean age 36 years (range 24-64) underwent arthroscopic treatment for FAI. Clinical outcome used WOMAC and Postel Merle d'Aubigné (PMA) scores. Radiological development of osteoarthritis (OA) was graded according to Tönnis score.
At mean final follow-up of 1.3 years (range 0.5-3), there were no complications of either type of traction technique used. Mean WOMAC score increased from 55 to 75 points and PMA from 14.6 to 16.7 points. The subjective overall satisfaction rate was 79%. Radiological OA changes appeared in two hips, were unchanged in 33, and deteriorated in three.
Invasive distraction device has been effective but appeared complex and costly. The procedure is now performed without it and begins at the peripheral compartment by the capsulotomy, which allows secondary distraction using a contralateral buttock. Preoperative OA seems to be a negative prognostic factor for clinical outcome.
Arthroscopic treatment of FAI is a safe technique which can be achieved without perineal complications. Limited anterior-superior capsulectomy and cephalic bone resection represent the first operative step, allowing acetabular trimming, labral reattachment and FAI relief. It is effective in terms of early clinical results.
Level IV: retrospective study.
髋关节镜治疗股骨髋臼撞击症（FAI）是一种微创治疗方法，可全面进入髋关节。
髋关节镜治疗可以缓解 FAI，而无需使用会阴部支撑。
描述两种类型的髋关节分离术治疗 FAI 的早期经验，不使用会阴部支撑；评估在关节镜控制下进行 FAI 释放的发病率及其早期临床和影像学结果。
在前 32 例中，该手术使用了一种侵入性牵开器，从中央间隙开始。在后 6 例中，它从外周间隙开始，使用专用的牵引台和对侧臀部支撑。纳入标准为：撞击试验阳性和 FAI 的影像学证据。38 例连续 FAI 患者平均年龄 36 岁（24-64 岁）。采用 WOMAC 和 Postel Merle d'Aubigné（PMA）评分评估临床疗效。根据 Tönnis 评分评估骨关节炎（OA）的放射学发展。
平均最终随访 1.3 年（0.5-3 年），两种牵引技术均无并发症。WOMAC 评分从 55 分增加到 75 分，PMA 从 14.6 分增加到 16.7 分。主观总体满意度为 79%。2 髋出现放射学 OA 改变，33 髋无变化，3 髋恶化。
侵入性牵开器有效，但操作复杂且成本高。现在不使用该设备，而是从外周间隙开始，通过关节囊切开术进行操作，允许使用对侧臀部进行二次牵开。术前 OA 似乎是临床结果的一个负面预测因素。
髋关节镜治疗 FAI 是一种安全的技术，可避免会阴部并发症。有限的前上囊切除术和头状骨切除术是第一步，可以进行髋臼修整、盂唇修复和 FAI 缓解。它在早期临床结果方面是有效的。
IV 级：回顾性研究。
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