Hip Arthroscopy Contributes to Management of FAI in Adolescents

Hip arthroscopy can be used in the management of adolescents with symptomatic femoroacetabular impingement, according to recent study data.

“This study reports favorable outcomes of arthroscopic management of [femoroacetabular impingement] FAI in adolescents with results at least comparable to an adult population. Concomitant procedures and revision surgery are both more common among adolescents and there is certainly a propensity for athletes in both groups,” J.W. Thomas Byrd, M.D., said.

Byrd and colleagues at the Nashville Sports Medicine Center (inTennessee) prospectively assessed 122 consecutive hips among 108 adolescent patients who had arthroscopic surgery for symptomatic FAI. The adolescent group was 55 percent female with an average age of 16 years. The matched control group was 122 patients with an average of 36 years and was 58 percent male. Minimum follow-up was one year with an average follow-up of 30 months. Overall, 96 percent of the adolescents participated in athletics compared with 61 percent of the adults in the control group.

The average improvement in the modified Harris Hip Score was 23 points for the adolescent group and 21 points for the adult group. For the adolescent group, FAI correction was performed for 36 cam and 17 pincer lesions and for 69 combined lesions. There were 111 labral tears that required 85 refixations and 26 debridements. There were 101 acetabular chondral lesions with four microfractures. There were three femoral chondral lesions. The researchers removed seven loose bodies and debrided 19 lesions of the ligamentum teres. Concomitant extraarticular procedures included 13 iliopsoas tendon releases and two iliotibial band tendinoplasties.

Among the adult cohort, the researchers performed FAI correction for 53 cam and 5 pincer lesions and for 64 combined lesions. There were 103 labral tears that required 52 refixations and 50 debridements. There were 112 acetabular chondral lesions with 20 microfractures and 17 femoral chondral lesions. The researchers removed 17 loose bodies and debrided 21 lesions of the ligamentum teres in the adult group. Concomitant extraarticular procedures included four iliopsoas tendon releases and one abductor repair.

Four adolescents needed repeat arthroscopic surgery and one patient underwent a periacetabular osteotomy. One adult patient had repeat arthroscopic surgery.