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. 2020 Sep;28(9):2763-2771.
doi: 10.1007/s00167-018-5026-z. Epub 2018 Jun 28.

Arthroscopic anterior inferior iliac spine decompression does not alter postoperative muscle strength

Satoshi Tateishi  1 , Yasuo Onishi  2 , Hitoshi Suzuki  2 , Makoto Takahashi  1 , Junichiro Shiraishi  1 , Christopher M Larson  1   3 , Soshi Uchida  4
Affiliations

Arthroscopic anterior inferior iliac spine decompression does not alter postoperative muscle strength

Satoshi Tateishi et al. Knee Surg Sports Traumatol Arthrosc. 2020 Sep.

Abstract

Purpose: The purpose of this study was to assess the additional effect of anterior inferior iliac spine (AIIS) decompression on knee extensor and hip flexor strength and compare functional outcomes after arthroscopic FAI correction with and without AIIS decompression.

Methods: Sixty patients who underwent arthroscopic FAI correction surgery were divided into two groups matched for AIIS morphology: 31 patients who underwent arthroscopic FAI surgery only (without AIIS decompression) (FAI group) (AIIS Type I; n = 5, Type II; n = 26, Type III; n = 0) and 29 patients who underwent arthroscopic FAI surgery with AIIS decompression (AIIS group) (AIIS Type I; n = 5, Type II; n = 24, Type III; n = 0). Knee extensor and hip flexor strength were evaluated preoperatively and at 6 months after surgery. Patient-reported outcome (PRO) scores using the modified Harris hip score (MHHS), the nonarthritic hip score (NAHS) and iHOT-12 were obtained preoperatively and at 6 months after surgery.

Results: In the AIIS group, there was no significant difference between knee extensor strength pre- and postoperatively (n.s.). In the AIIS group, hip flexor strength was significantly improved postoperatively compared to preoperative measures (p < 0.05). In the FAI group, there were no significant improvements regarding muscle strength (n.s.). While there were no significant differences of preoperative and postoperative MHHS and NAHS between both groups (MHHS; n.s., NAHS; n.s.), the mean postoperative iHOT-12 in the FAI group was inferior to that in the AIIS group. (p < 0.01). The revision surgery rate for the AIIS group was significantly lower compared with that in the FAI group (p < 0.05).

Conclusion: Anterior inferior iliac spine decompression, as a part of an arthroscopic FAI corrective procedure, had a lower revision surgery rate and did not compromise knee extensor and hip flexor strength, and it improved clinical outcomes comparable to FAI correction without AIIS decompression. AIIS decompression for FAI correction improved postoperative PRO scores without altering the muscle strength of hip flexor and knee extensor.

Level of evidence: III.

Keywords: Anterior inferior iliac spine; Femoroacetabular impingement; Hip arthroscopy; Muscle strength; Rehabilitation; Subspinal impingement.

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Conflict of interest statement

One of the authors (S.U) is a consultant for Smith & Nephew and Zimmer-Biomet and receives research fund from Smith & Nephew and Stryker. CL is a consultant for Smith & Nephew and A3 surgical. This article is not related to any funds. Each author certifies that he has no commercial associations (e.g, consultancies, stock ownership, equity interest, patent/licencing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.

Figures

Fig. 1
Fig. 1
Flow chart of patient selection
Fig. 2
Fig. 2
Images of 3D-CT before the primary operation, postoperatively, after revision surgery. It shows that the bulge of AIIS remaining after primary operation has disappeared after revision surgery
See this image and copyright information in PMC

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