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Topic:

Femoral Acetabular Impingement

Issue:

Hip

Category:

Developmental

Title:

Comparison of Gait and Functional Outcomes Between Open and Arthroscopic Treatment of Adolescent and Young Adult Femoroacetabular Impingement

Author:

Morris, William Z. MD; Loewen, Alex MS; Ulman, Sophia PhD; Johnson, Ben PA-C; Sucato, Daniel J. MS, MD; Podeszwa, David A. MD; Ellis, Henry B. MD

Journal:

Journal of Pediatric Orthopaedics

Date:

January 2024

Reference:

44(1): p 22-27, DOI: 10.1097/BPO.0000000000002532

Level Of Evidence:

II

# of Patients:

55

Study Type:

Prospective study

Location:

Not specified

Summary:

This study compares gait and functional outcomes in adolescent and young adult patients with femoroacetabular impingement (FAI) treated with either open surgical hip dislocation (SHD) or arthroscopic surgery.

Methods:

Inclusion Criteria: Adolescent/young adult patients (≤20 years old) with FAI undergoing SHD or arthroscopic surgery. Exclusion Criteria: Not specified. Intervention: Comparison of gait and functional outcomes after SHD versus arthroscopic surgery for FAI. Outcomes Measured: Gait assessment: Barefoot walking with analysis of hip flexion, trunk, pelvis, and hip kinematics. Balance assessment: 30-second single-limb balance trial on the affected side. Clinical outcomes: Harris Hip Score preoperatively and postoperatively (minimum 8 months). Data Analysis: Paired-samples t-test for within-group comparisons. Independent samples t-test for between-group comparisons (α=0.05).

Exclusions:

Not specified

Results:

Pre- to Postoperative Improvements in Harris Hip Score: SHD group: From 64.8 ± 16.4 to 81.8 ± 17.8 (P < 0.001). Arthroscopy group: From 57.0 ± 16.7 to 84.7 ± 19.7 (P < 0.001). Gait Analysis: Significant increase in maximum hip flexion for SHD group (32.3 ± 5.7 to 36.1 ± 5.2, P = 0.003). No significant changes in trunk, pelvis, or hip kinematics in either group. Balance Task: The arthroscopy group showed a significantly longer balance duration (18.8 ± 7.8 seconds) compared to the SHD group (14.2 ± 2.7 seconds, P = 0.008). No significant differences in trunk or pelvis position during balance.

Conclusions:

Both SHD and arthroscopic surgery for FAI resulted in significant clinical improvements with no clinically significant abductor dysfunction after 1 year. The arthroscopy group demonstrated superior balance performance compared to the SHD group postoperatively. Further studies are needed to investigate more dynamic tasks to assess potential differences between treatment groups.

Relevance:

Limitations:

Perspective:

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