Skip Navigation LinksHome > April/May 2014 - Volume 34 - Issue 3 > Open Surgical Treatment of Femoroacetabular Impingement in A...
Journal of Pediatric Orthopaedics:
doi: 10.1097/BPO.0000000000000093
Hip/Femur

Open Surgical Treatment of Femoroacetabular Impingement in Adolescent Athletes: Preliminary Report on Improvement of Physical Activity Level

Novais, Eduardo N. MD*; Heyworth, Benton E. MD; Stamoulis, Caterina PhD; Sullivan, Kristen BSc; Millis, Michael B. MD; Kim, Young-Jo MD, PhD

Collapse Box

Abstract

Background:

The surgical dislocation of the hip (SDH) approach has gained popularity in the treatment of femoroacetabular impingement (FAI) secondary to pediatric hip disorders. However, it has been suggested that SDH may preclude a return to previous levels of function in athletes. The purpose of this study was (1) to determine the level of activity and pain in young athletes before and after open hip surgery through an SDH approach for the treatment of FAI; (2) to investigate how clinical improvement correlates with physical activity; (3) to determine whether articular cartilage injury and the complexity of surgical procedures are associated with improvement in activity level and pain.

Methods:

SDH was utilized in 29 young athletes treated for symptomatic FAI (20 males 9 females, age range 12.7 to 20.7 years (mean age, 17 y)). Evaluation included sport(s) played, University of California Los Angeles (UCLA) physical activity level, and clinical outcome in terms of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)-Pain scores. Intraoperative articular cartilage status and anteroposterior pelvic and lateral hip radiographs were assessed.

Results:

All patients had regularly participated in one or more of 13 distinct sports. The median UCLA score increased with marginal significance (P=0.057) after surgery. Change in the level of pain from preoperatively to postoperatively, as measured by the WOMAC-Pain subscale, was found to be statistically significant (P=0.0024). A statistically significant correlation between changes in UCLA and WOMAC was estimated (ρ=−0.61, P≤0.001). No statistically significant correlation was found between change in UCLA and the addition of a second procedure other than femoral head-neck osteochondroplasty. Finally, no statistically significant correlation was found between severity of cartilage injury and change in UCLA or WOMAC scores. The femoral α-angle improved an average of 22.7 degrees (P<0.001) after surgery.

Conclusions:

Pain relief and maintenance or improvement in activity level may be achieved with open FAI surgery through an SDH approach in young athletes. Although this approach is more invasive than hip arthroscopy, it should be considered in the management of adolescents with FAI and complex hip deformities associated with pediatric disorders such as slipped capital femoral epiphysis and Perthes disease.

Level of Evidence:

Level IV—case series; retrospective.

Copyright © 2013 by Lippincott Williams & Wilkins

The Pediatric Orthopaedic Society of North America (POSNA)
is a group of healthcare professionals, primarily pediatric orthopaedic surgeons, dedicated to advancing musculoskeletal care of children and adolescents. JPO is our official member journal. 
Like us on facebook and become a member today!

Login

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.