Note: To access the video accompanying this report, visit the February issue of Arthroscopy at www.arthroscopyjournal.org.
Arthroscopy: The Journal of Arthroscopic & Related Surgery
Systematic Review With Video IllustrationComparative Systematic Review of the Open Dislocation, Mini-Open, and Arthroscopic Surgeries for Femoroacetabular Impingement
Section snippets
Methods
Four databases were selected to ensure a comprehensive review of the literature: PubMed, EMBASE, Ovid, and the Cochrane Review. On January 25, 2010, a total of 13 different queries were used for each engine: (1) “femoroacetabular impingement OR FAI,” (2) “hip impingement,” (3) “cam impingement,” (4) “pincer impingement,” (5) “surgical dislocation AND impingement,” (6) “osteotomy AND impingement,” (7) “hip AND treatment AND impingement,” (8) “hip arthroscopy,” (9) “mini-open,” (10) “Hueter AND
Results
Use of the previously mentioned terms resulted in a total of 5,856 articles for further review, with 3,278 of those from PubMed, 1,281 from EMBASE, 1,295 from Ovid, and 2 from the Cochrane Review. An additional 53 articles resulted from the aforementioned hand search. A total of 950 articles were selected for further abstract review. The resulting 55 articles were then obtained in full-text format for further analysis. Of the 55 articles that met inclusion criteria, 22 met the inclusion
Discussion
Clohisy et al.15 performed a systematic review of FAI surgical outcome studies. They reviewed 11 studies, of which 1 used the mini-open technique. They found an overall clinical success rate varying from 65% to 96% over a mean follow-up period of 3.2 years, an improvement in pain and function in all studies, a total hip conversion rate between 0% and 26%, and a complication rate of 0% to 18%. No comparisons were made between surgical methods.
A systematic review by Bedi et al.16 looked at the
Conclusions
The open dislocation, mini-open, and arthroscopic methods for treating symptomatic FAI are effective in improving pain and function in short-term to midterm studies and are relatively safe procedures (Table 6). The historical gold standard of open dislocation surgery had a comparatively high major complication rate primarily because of trochanteric osteotomy–related issues. The mini-open method showed comparable efficacy but a significant incidence of iatrogenic injury to the LFCN in some
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The authors report no conflict of interest.