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Anterolateral Approach in the Treatment of Femoroacetabular Impingement of the Hip

BACKGROUND: Ganz surgical hip dislocation via a posterior (Kocher-Langenbeck) approach is a popular procedure in the management of femoroacetabular impingement (FAI). We report the results of surgery performed through an anterolateral (Watson-Jones) approach in the management of anterolateral FAI. M...

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Autores principales: Kim, Hui Taek, Kim, Um Ji, Cho, Yoon Je
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Orthopaedic Association 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6695336/
https://www.ncbi.nlm.nih.gov/pubmed/31475056
http://dx.doi.org/10.4055/cios.2019.11.3.337
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author Kim, Hui Taek
Kim, Um Ji
Cho, Yoon Je
author_facet Kim, Hui Taek
Kim, Um Ji
Cho, Yoon Je
author_sort Kim, Hui Taek
collection PubMed
description BACKGROUND: Ganz surgical hip dislocation via a posterior (Kocher-Langenbeck) approach is a popular procedure in the management of femoroacetabular impingement (FAI). We report the results of surgery performed through an anterolateral (Watson-Jones) approach in the management of anterolateral FAI. METHODS: Twenty-one hips in 20 patients (mean age at the time of operation, 17.3 years) were treated surgically using an anterolateral approach: 12 hips with Legg-Calvé-Perthes disease, three septic hips, three hips with avascular necrosis (combined with slipped capital femoral epiphysis [SCFE], femoral neck fracture, and developmental dislocation of the hip), two hips with epiphyseal dysplasia, and one hip with SCFE. All patients had anterolateral FAI. Surgical hip dislocation was performed in four hips with trochanteric osteotomy. Combined osteotomies were for neck lengthening in 11 hips, varus or valgus osteotomy in the proximal femur in four hips, and pelvic osteotomy in four hips. Clinical results were evaluated using a modified Harris hip score (mHHS). RESULTS: Range of hip flexion and abduction showed statistically significant improvement after surgery; however, the improvement in mean mHHS was not statistically significant. CONCLUSIONS: An anterolateral approach can be used as an alternative to a posterior approach in the management of anterolateral FAI with or without hip dislocation while safely preserving the blood supply to the femoral head and allowing simultaneous procedures in the proximal femur.
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spelling pubmed-66953362019-09-01 Anterolateral Approach in the Treatment of Femoroacetabular Impingement of the Hip Kim, Hui Taek Kim, Um Ji Cho, Yoon Je Clin Orthop Surg Original Article BACKGROUND: Ganz surgical hip dislocation via a posterior (Kocher-Langenbeck) approach is a popular procedure in the management of femoroacetabular impingement (FAI). We report the results of surgery performed through an anterolateral (Watson-Jones) approach in the management of anterolateral FAI. METHODS: Twenty-one hips in 20 patients (mean age at the time of operation, 17.3 years) were treated surgically using an anterolateral approach: 12 hips with Legg-Calvé-Perthes disease, three septic hips, three hips with avascular necrosis (combined with slipped capital femoral epiphysis [SCFE], femoral neck fracture, and developmental dislocation of the hip), two hips with epiphyseal dysplasia, and one hip with SCFE. All patients had anterolateral FAI. Surgical hip dislocation was performed in four hips with trochanteric osteotomy. Combined osteotomies were for neck lengthening in 11 hips, varus or valgus osteotomy in the proximal femur in four hips, and pelvic osteotomy in four hips. Clinical results were evaluated using a modified Harris hip score (mHHS). RESULTS: Range of hip flexion and abduction showed statistically significant improvement after surgery; however, the improvement in mean mHHS was not statistically significant. CONCLUSIONS: An anterolateral approach can be used as an alternative to a posterior approach in the management of anterolateral FAI with or without hip dislocation while safely preserving the blood supply to the femoral head and allowing simultaneous procedures in the proximal femur. The Korean Orthopaedic Association 2019-09 2019-08-12 /pmc/articles/PMC6695336/ /pubmed/31475056 http://dx.doi.org/10.4055/cios.2019.11.3.337 Text en Copyright © 2019 by The Korean Orthopaedic Association http://creativecommons.org/licenses/by-nc/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Kim, Hui Taek
Kim, Um Ji
Cho, Yoon Je
Anterolateral Approach in the Treatment of Femoroacetabular Impingement of the Hip
title Anterolateral Approach in the Treatment of Femoroacetabular Impingement of the Hip
title_full Anterolateral Approach in the Treatment of Femoroacetabular Impingement of the Hip
title_fullStr Anterolateral Approach in the Treatment of Femoroacetabular Impingement of the Hip
title_full_unstemmed Anterolateral Approach in the Treatment of Femoroacetabular Impingement of the Hip
title_short Anterolateral Approach in the Treatment of Femoroacetabular Impingement of the Hip
title_sort anterolateral approach in the treatment of femoroacetabular impingement of the hip
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6695336/
https://www.ncbi.nlm.nih.gov/pubmed/31475056
http://dx.doi.org/10.4055/cios.2019.11.3.337
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