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Evaluation of the alpha angle as a predictor of outcome in the arthroscopic management of hip labral disease

Bloomfield, Michael R.; Courtney, Christopher D.; Klika, Alison K.; Lee, Ho H.; Arsoy, Diren; Krebs, Viktor E.; Barsoum, Wael K.

doi: 10.1097/BCO.0b013e3182311652

Background: Femoroacetabular impingement is a pre-arthritic condition that, if untreated, may predispose to inferior outcomes after hip arthroscopy. The objective of this study was to evaluate the effect of the alpha angle (AA), an indicator of cam-impingement lesions, on mid-term outcomes in patients undergoing arthroscopic labral debridement without femoral osteoplasty.

Methods: Consecutive patients with available imaging who underwent hip arthroscopy for a labral tear from 2001–2006 by two surgeons were retrospectively reviewed. Patients were contacted at a mean of 63.8 months (range 39.8–96.4 months) and administered a standardized telephone survey. Mid-term outcomes were considered successful if patients had no further surgery, had a “good” or “excellent” subjective rating of hip function and less than 5/10 average daily pain on telephone follow-up. Patients with significant osteoarthritis seen on the preoperative films or at the time of arthroscopy were omitted, leaving 55 patients available for mid-term follow-up.

Results: At mid-term follow-up, the average AA values of the successful (AA=51.1±10.7; 51%) and unsuccessful (AA=52.8±14.0; 49%) outcome groups were not significantly different (P=0.61). No significant differences were found between groups with an AA <50.5° and an AA ≥50.5° (P=0.47).

Conclusions: Our results indicate that the preoperative AA may not be a univariate major predictor of outcome after arthroscopic labral debridement.

Department of Orthopaedic Surgery, Orthopaedic and Rheumatologic Institute, Cleveland Clinic, Cleveland, Ohio.

Financial Disclosure: Wael Barsoum is a paid consultant for Stryker Orthopaedics and Shukla Medical and receives royalties from Stryker Orthopaedics, Exactech, Wright Medical, and Shukla Medical, as well as, stock options from Otismed. Viktor Krebs is a paid consultant for Stryker Orthopaedics, Shukla Medical and Salient Surgical Technologies. No relationships/conditions/circumstances present a potential conflict of interest pertaining to this work.

Correspondence to: Alison K. Klika, Department of Orthopaedic Surgery, A41, Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH 44195. Tel: +216 444 4954; fax: +216 445 6255; e-mail:

© 2011 Lippincott Williams & Wilkins, Inc.