Surgery for Femoroacetabular Impingement in Skeletally Immature Patients: Radiographic and Clinical Analysis

Objectives: The improved recognition of symptomatic femoroacetabular impingement (FAI) has lead to an emphasis of early diagnosis and treatment in the adolescent population. The purpose of this study was to evaluate the radiographic and clinical outcomes in patients with open physes that underwent h...

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Bibliographic Details
Published in:Orthopaedic journal of sports medicine 2017-07, Vol.5 (7_suppl6)
Main Authors: Ross, James R., Stone, Rebecca M., Ramos, Nicole M., Bedi, Asheesh, Larson, Christopher M.
Format: Article
Language:English
Subjects:
Clinical outcomes
Orthopedics
Pain
Sports medicine
Online Access:Get full text
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Summary:Objectives: The improved recognition of symptomatic femoroacetabular impingement (FAI) has lead to an emphasis of early diagnosis and treatment in the adolescent population. The purpose of this study was to evaluate the radiographic and clinical outcomes in patients with open physes that underwent hip arthroscopy for the treatment of symptomatic FAI. Additionally, we describe the three-dimensional (3D) pathomorphology in this unique population. Methods: We retrospectively reviewed 39 hips (28 patients; 75% male) with a mean age 15.8 years (range, 12.8-19.3 years) with FAI, who additionally demonstrated open physes on pre-operative radiographs. Radiographic parameters included the lateral center edge (LCE), Tonnis angle, AP and lateral alpha angle and head-neck offset ratio (HNOr). Each patient also underwent a pre-operative CT scan, which was utilized for the evaluation for femoral and acetabular measurements and simulated range of motion (ROM) to impingement. Preoperative and post-operative functions were evaluated prospectively using the modified Harris Hip Score (mHHS) and pain on a visual analogue scale (VAS). All patients participated in organized athletics and 50% were in multiple sports year round. Results: All patients (100%) within this cohort had open femoral neck and iliac crest physis. The ischial tuberosity and greater trochanteric physes were open in 95% and 54% of the hips respectively. Although there was no significant difference between pre-operative and post-operative LCE and Tonnis angles, the alpha angle and HNOr were significantly improved (39.7° vs. 61.7°; p
ISSN:2325-9671
2325-9671
DOI:10.1177/2325967117S00259