Efficacy of Osseous Abnormalities Correction with Arthroscopic Surgery in Femoroacetabular Impingement

Femoroacetabular impingement (FAI) is a clinical syndrome characterized by subtle abnormal morphology of the proximal femur and/or the acetabulum that leads to abnormal contact between the femoral neck and the acetabular rim during the hip range of motion. Traditionally, FAI has been managed safely and effectively with surgical hip dislocation; less invasive arthroscopic techniques are now being used to an increasing extent, trying to emulate the results of the open technique. The purpose of this study was to evaluate the radiographic results of arthroscopic acetabular rim trimming and femoral osteochondroplasty in FAI. This was a retrospective analysis of preoperative and postoperative plain radiographs of 80 patients treated for FAI with arthroscopic surgery between April 2007 and December 2008. We evaluated 2 parameters: the Wiberg angle (center-edge angle) (normal, 25°-35°), and the anterior/posterior relation of femoral head-neck offset (normal, 0.8-1). Of 80 hips, 10 (12.5%) were pincer-type impingement, 17 (21.25%) were cam type, and 53 (66.25%) were mixed type. The preoperative Wiberg average was 39° (range, 25°-51°), and the postoperative Wiberg average was 32° (range, 25°-42°). The preoperative anterior/posterior femoral offset relation average was 0.42 (range, −0.38 to 1), and the postoperative anterior/posterior femoral offset relation average was 0.94 (range, 0.61-1.2). Our results show that it is possible to obtain an anatomical correction of the osseous abnormalities with arthroscopic surgery in FAI. Level of evidence: level III.