Open Access, Peer-reviewed
pISSN 1226-2102
eISSN 2005-8918
    J Korean Orthop Assoc. 2011 Aug;46(4):303-311. Korean.
    Published online Aug 31, 2011.
    https://doi.org/10.4055/jkoa.2011.46.4.303
    Copyright © 2011 by The Korean Orthopaedic Association
    Original Article

    Arthroscopic Treatment of Femoroacetabular Impingement in Young Taekwondo Players

    Pil-Sung Kim, M.D.,* Deuk-Soo Hwang, M.D., Chan Kang, M.D., Jung-Bum Lee, M.D.,† Woo-Wong Lee, M.D. and Sun-Cheol Han, M.D.
      • Department of Orthopedic Surgery, Chungnam National University School of Medicine, Daejeon, Korea.
      • *Department of Orthopedic Surgery, Bumin Hospital, Seoul, Korea.
      • †Department of Orthopedic Surgery, Konyang University College of Medicine, Daejeon, Korea.
    • Correspondence to: Deuk-Soo Hwang, M.D. Department of Orthopedic Surgery, Chungnam National University School of Medicine, #33, Munhwa-ro, Jung-gu, Daejeon 301-721, Korea. TEL: +82-42-280-7350, FAX: +82-42-252-7098, Email: dshwang@cnu.ac.kr
    Received October 12, 2010; Accepted March 22, 2011.

    This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

    Abstract

    Purpose

    We wanted to evaluate the clinical results and the radiological and arthroscopic findings of femoroacetabular impingement (FAI) in young Taekwondo players and to investigate the rate of returning-to-play Taekwondo and the recurrence rate.

    Materials and Methods

    Twenty Taekwondo players (16 males and, 4 females) who were arthroscopically treated for FAI from September 2003 to July 2008 were retrospectively analyzed. Their mean age was 21.6 years old (range: 17 to 32 years) and the mean follow up was 33.7 months (range: 24 to 71 months). Plain radiographs and 3 dimensional computed tomography were taken in all patients and magnetic resonance arthrography was performed in 11 with suspicious soft tissue lesions. Labral injury, cartilage injury and associated lesions were evaluated by arthroscopy. The preoperative and postoperative visual analogue scale (VAS), the modified Harris hip score (MHHS), the sports frequency score (SFS), and the non-arthritic hip score (NAHS) were compared. We investigated the rate of returning-to-play at postoperative 1 year and at postoperative 2 years and the recurrence rate within 2 years after surgery.

    Results

    There were 10 cam types, 1 pincer type and 9 mixed types. The mean alpha angle improved from 65.8 degrees preoperatively to 43.2 degrees postoperatively (p<0.001). Acetabular labral tears were accompanied in all cases and the most common tear site and type were at 2 o'clock and degenerative tear, respectively. In descending order, the acetabular cartilage injuries were located in the anterosuperior, posteroinferior and anterior portion, respectively. The femoral cartilage injuries were mostly located in the anterosuperior portion. The range of motion at the final follow-up showed improvement in all except abduction (p=0.262). The VAS, MHHS and SFS showed statistically significant improvement (p<0.001). The NAHS was improved, but without statistical significance (p=0.31). The rates of returning-to-play at postoperative 1 year and postoperative 2 years were 85% (17/20) and 75% (15/20), respectively. The recurrence rate within postoperative 2 years was 15% (3/20).

    Conclusion

    As screening test for FAI in young Taekwondo players is necessary at the beginning of Taekwondo. Arthroscopic treatment in symptomatic Taekwondo players is an effective procedure that can improve the postoperative exercise frequency and function. Returning-to-play Taekwondo is associated with the clinical improvements and the patients' will.

    Keywords
    femoroacetabular impingement; arthroscopic treatment; Taekwondo

    Figures

    Figure 1
    (A) A frog leg lateral radiograph of a 18-year-old woman professional Taekwondo player, shows a secondary change (black arrow) of the right femoral head-neck junction by pincer impingement. (B) An oblique axial image of CT shows a bump (black arrow) on the right femoral head-neck junction. (C) 3D-CT image. (D) Arthroscopic finding: A debonding unstable acetabular cartilage with labral tear. (E) We performed labral refixation after acetabuloplasty. (F) Arthroscopic femoroplasty was performed.

    Figure 2
    (A) A plain hip AP radiograph of a 22-year-old man, who was a professional Taekwondo player, shows acetabular retroversion (white arrow) on left hip. (B) Plain hip frog leg lateral radiograph shows a finding of decreased femoral offset and femoral flattening (black arrow). (C) Arthroscopic finding: A labrum at 3 o'clock was torn. (D) Acetabuloplasty after partial labrectomy was performed. (E) Femoroplasty was performed.

    Tables

    Table 1
    Changes of Range of Motion

    Table 2
    Changes between the Preoperative and Postoperative Scores

    Table 3
    Changes of the Sports Frequency Score between the Preoperative and at 1 Year Postoperatively

    Table 4
    The Rate of Returning-to-play Taekwondo at 1 Year Postoperatively, at 2 Years Postoperatively and the Recurrence Rate within 2 Years Postoperatively

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    MeSH Terms
    Arthrography
    Arthroscopy
    Cartilage
    Femoracetabular Impingement
    Follow-Up Studies
    Hip
    Humans
    Magnetic Resonance Spectroscopy
    Male
    Mass Screening
    Range of Motion, Articular
    Recurrence
    Retrospective Studies
    Sports
    Sulfides
    Metrics
    Share
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    Tables
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