Treatment of femoroacetabular impingement: A systematic review

被引：53
作者：
Harris J.D. [1 ]
Erickson B.J. [1 ]
Bush-Joseph C.A. [1 ]
Nho S.J. [1 ]
机构：
[1] Department of Orthopedic Surgery, Rush Medical College of Rush University, Rush University Medical Center, Chicago IL 60612
来源：
Current Reviews in Musculoskeletal Medicine | 2013年 / 6卷 / 3期
关键词：
Arthroscopy; Femoroacetabular impingement; Hip; Labral tear; Surgical dislocation;
D O I：
10.1007/s12178-013-9172-0
中图分类号：
学科分类号：
摘要：
The purpose of this review is to determine if there is a difference in outcomes after: (1) nonsurgical vs surgical treatment of FAI; (2a) surgical dislocation with greater trochanteric osteotomy, (2b) anterior mini-open, (2c) arthroscopic plus mini-open, and (2d) arthroscopic surgery for FAI; (3) difference in complication and re-operation rates; and (4a) labral refixation and (4b) labral debridement for labral injuries. A systematic review of multiple databases was performed after PROSPERO registration and using PRISMA guidelines. Level I-IV evidence clinical studies with minimum 2-year follow-up were included. Data were compared using 2-sample and 2-proportion Z-test calculators. Study methodological quality was analyzed using Modified Coleman Methodology Score (MCMS). Recommendations were made using SORT (Strength Of Recommendation Taxonomy). Twenty-nine studies were included (2369 subjects; 2507 hips). MCMS was poor. Mean subject age was 34.4+/-8.4 years and mean follow-up was 3.1+/-0.9 years. Statistically significant differences were observed following both nonsurgical and surgical treatment, with greater (P < 0.05) improvements following surgery (SORT B), without consistent significant differences observed between different surgical techniques (SORT C). There was a greater (P < 0.05) reoperation and complication rate following surgical dislocation vs mini-open and arthroscopic techniques (SORT A). Clinical outcomes were significantly better (P < 0.05) following labral refixation vs debridement (SORT B). Outcomes of operative treatment of femoroacetabular impingement are significantly better than nonsurgical management. Surgical treatment significantly improves outcomes, with no consistent significant differences exhibited between open and arthroscopic techniques. Open surgical dislocation has significantly greater reoperation and complication rates vs mini-open and arthroscopic techniques. Outcomes of labral refixation are significantly better than debridement in patients with labral injuries. © 2013 Springer Science+Business Media New York.
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页码：207 / 218
页数：11
相关论文
共 46 条
[21]  
Javed A., O'Donnell J.M., Arthroscopic femoral osteochondroplasty for cam femoroacetabular impingement in patients over 60 years of age, J Bone Joint Surg Br, 93, pp. 326-331, (2011)
[22]  
Byrd J.W., Jones K.S., Arthroscopic management of femoroacetabular impingement: Minimum 2-year follow-up, Arthroscopy, 27, pp. 1379-1388, (2011)
[23]  
Kempthorne J.T., Armour P.C., Rietveld J.A., Hooper G.J., Surgical dislocation of the hip and the management of femoroacetabular impingement: Results of the Christchurch experience, ANZ J Surg, 81, pp. 446-450, (2012)
[24]  
Nho S.J., Magennis E.M., Singh C.K., Kelly B.T., Outcomes after the arthroscopic treatment of femoroacetabular impingement in a mixed group of high-level athletes, Am J Sports Med., 39, SUPPL., (2011)
[25]  
Clohisy J.C., Zebala L.P., Nepple J.J., Pashos G., Combined hip arthroscopy and limited open osteochondroplasty for anterior femoroacetabular impingement, J Bone Joint Surg Am, 92, pp. 1697-1706, (2010)
[26]  
Peters C.L., Schabel K., Anderson L., Erickson J., Open treatment of femoroacetabular impingement is associated with clinical improvement and low complication rate at short-term follow-up, Clin Orthop Relat Res, 468, pp. 504-510, (2010)
[27]  
Horisberger M., Brunner A., Herzog R.F., Arthroscopic treatment of femoroacetabular impingement of the hip: A new technique to access the joint, Clin Orthop Relat Res, 468, pp. 182-190, (2010)
[28]  
Philippon M.J., Weiss D.R., Kuppersmith D.A., Briggs K.K., Hay C.J., Arthroscopic labral repair and treatment of femoroacetabular impingement in professional hockey players, Am J Sports Med., 38, 1, pp. 99-104, (2010)
[29]  
Laude F., Sariali E., Nogier A., Femoroacetabular impingement treatment using arthroscopy and anterior approach, Clin Orthop Relat Res, 467, pp. 747-752, (2009)
[30]  
Graves M.L., Mast J.W., Femoroacetabular impingement: Do outcomes reliably improve with surgical dislocations?, Clin Orthop Relat Res, 467, pp. 717-723, (2009)
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