Arthroscopic treatment for symptomatic bilateral cam-type femoroacetabular impingement.

摘要

Arthroscopic femoral osteochondroplasty improves clinical outcome in patients with unilateral cam-type femoroacetabular impingement. The goal of this study was to evaluate the clinical outcome and pathological similarities in patients who have had bilateral arthroscopic femoral osteochondroplasy for cam-type femoroacetabular impingement. The study group included 82 patients who had sequential bilateral hip arthroscopies for symptomatic cam-type femoroacetabular impingement with a minimum of 12 months follow-up. All patients had bilateral restricted hips at presentation. We differentiated between patients who had bilateral painful hips and those with unilateral pain at presentation. Scores and surgical findings were compared between the 2 study groups and between bilateral surgeries in each group. Pre- and postoperative Modified Harris Hip Scores and Non-Arthritic Hip Scores were undertaken prospectively by an independent observer. Mean patient age at the first surgery was 29 years (range, 14-63 years). The average time difference between arthroscopies was 5 months (range, 0.3-30 months). Postoperative scores improved significantly in both study groups in the first and second (contralateral) surgeries. Intra-articular pathologies between sides were linearly correlated for both groups. The time interval between surgeries had a linear correlation to age, reverse correlation to chondral damage, and reverse correlation to postoperative scores at the first surgery. Our results suggest that symptomatic patients with cam-type femoroacetabular impingement have similar accompanied pathologies on both sides and can benefit from sequential arthroscopic osteochondroplasty.