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. 2021 Apr;45(4):907-913.
doi: 10.1007/s00264-020-04887-1. Epub 2020 Nov 23.

A novel concept of cam-type femoroacetabular impingement treatment with patient-specific template guided osteochondral deformity ablation

Rene Mihalič  1 , Peter Brumat  2 , Rihard Trebše  2   3
Affiliations

A novel concept of cam-type femoroacetabular impingement treatment with patient-specific template guided osteochondral deformity ablation

Rene Mihalič et al. Int Orthop. 2021 Apr.

Abstract

Purpose: To present a novel surgical concept for the cam-type femoroacetabular impingement (FAI) treatment and to assess and report the clinical outcomes.

Methods: We performed a retrospective study of a single-surgeon case series of six hips in five consecutive male patients with symptomatic cam-type FAI, treated with the mini-open anterior hip approach with a patient-specific template (PST)-guided deformity ablation between 2015 and 2018. We assessed the hip range of motion, iHOT-33, Tegner, and EQ-5D before surgery and after a minimum follow-up of 30 months.

Results: The average age was 37 ± 13.3 years, average BMI was 31.1 ± 3.3 kg/m2, and average pre-surgery Tönnis hip osteoarthritis (OA) grade was 1 ± 1. The average surgery duration was 71 ± eight minutes. The average estimated blood loss was 83 ± 26 ml. After a mean follow-up of 50 ± 12 months, we observed no OA progression with no change in Tönnis hip OA grades. Hip flexion and internal rotation significantly improved (p = 0.007; p = 0.048) from mean 98° ± 9° and 14° ± 11° to mean 113° ± 8° and 23° ± 8°, respectively. iHOT-33, Tegner, and EQ-5D improved significantly (p = < 0.001; p = 0.004; p = < 0.001) from mean 44.7 ± 12.2, 3 ± 1, and 0.513420 ± 0.101389 to mean 94 ± 2.7, 5 ± 1, and 1.000000 ± 0, respectively. One patient needed revision surgery for heterotopic ossification removal, with no sequelae at the last follow-up.

Conclusion: Mini-open anterior hip approach with the PST-guided cam-type FAI deformity ablation presents an accurate and reproducible solution for cam-type FAI surgical treatment, with promising clinical outcomes. Using a PST in the cam-type FAI surgery may present a powerful additional tool in the existing open techniques armamentarium.

Keywords: Cam impingement; FAI; Femoroacetabular impingement; PST; Patient-specific template.

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References

    1. Jauregui JJ, Salmons HI, Meredith SJ et al (2020) Prevalence of femoro-acetabular impingement in non-arthritic patients with hip pain: a meta-analysis. Int Orthop. https://doi.org/10.1007/s00264-020-04857-7
    1. Schafer KA, Clohisy JC, Nepple JJ (2020) Rapidly progressive arthritis in femoroacetabular impingement: patient characteristics and risk factors for total hip arthroplasty by the age of forty. Iowa Orthop J 40:6
    1. Kohn MD, Sassoon AA, Fernando ND (2016) Classifications in brief: Kellgren-Lawrence classification of osteoarthritis. Clin Orthop Relat Res 474:1886–1893. https://doi.org/10.1007/s11999-016-4732-4 - DOI - PubMed - PMC
    1. Hellman MD, Riff AJ, Frank RM et al (2014) Operative treatment of femoroacetabular impingement. Phys Sportsmed 42:112–119. https://doi.org/10.3810/psm.2014.09.2082 - DOI
    1. Diaz-Ledezma C, Parvizi J (2013) Surgical approaches for cam femoroacetabular impingement: the use of multicriteria decision analysis. Clin Orthop 471:2509–2516. https://doi.org/10.1007/s11999-013-2934-6 - DOI

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