ObjectiveTo assess the mid-term effecitveness of femoroacetabular impingement (FAI) treated by surgical hip dislocation.MethodsBetween April 2014 and August 2015, 15 patients (16 hips) with FAI were enrolled in the study and treated with surgical hip dislocation. There were 12 males and 3 females with an average age of 36.6 years (range, 22-59 years). Among them, 14 cases involved in unilateral hip and 1 in bilateral hips. The mean disease duration was 28 months (range, 4-120 months). Preoperative visual analogue scale (VAS) score and Harris hip score were 7.9±1.0 and 44.1±9.3, respectively.ResultsAll incisions healed by first intention. There was no main complication, such as vessel and nerve injuries and infection. All 15 patients were followed up 30-46 months (mean, 39.5 months). The VAS score was 2.5±1.6 at 3 months and 0.5±0.7 at last follow-up. The Harris score was 85.5±4.4 at 3 months and 95.6±3.9 at last follow-up. There were significant differences in two scores between pre- and post-operation and between 3 months and last follow-up (P<0.05). The satisfaction rate of hip function was 93.8% (15/16) at last follow-up. X-ray examination showed that there was no sign of impingment at the femoral head and neck and acetabulum forming site of the affected hip joint, and no complication such as loosening of internal fixator, nonunion of osteotomy, avascular necrosis of femoral head, and heterotopic ossification occurred during follow-up.ConclusionThe surgical hip dislocation is a safe and effective way to treat FAI in the mid-term follow-up, which can repair torn labrum and trim acetabulum and femoral neck.
Objective To summarize the biomechanical characteristics, diagnosis, and hip arthroscopic treatment of borderline developmental dysplasia of hip (BDDH) with Cam-type femoroacetabular impingement (Cam FAI). Methods The literature on BDDH with Cam FAI at home and abroad in recent years was extensively reviewed and analyzed. Results In patients with BDDH and Cam FAI, the femoral neck anteversion angle and femoral neck shaft angle increase, the pelvis tilts, and the acetabulum rotates, resulting in instability of the hip joint. In order to maintain the stability of the hip joint, the direction of biomechanical action of the hip joint has changed, which further affects the anatomical structures such as the proximal femur and acetabular morphology. BDDH with Cam FAI can be diagnosed clinically by combining lateral center edge angle, anterior center edge angle, and acetabular index. BDDH with Cam FAI can be effectively treated through arthroscopic polishing of the edges of the acetabular proliferative bone, excision of Cam malformations, and minimally invasive repair of the glenoid lip and cartilage of the hip joint. Conclusion Currently, there is no unified standard for the diagnosis and treatment of BDDH with Cam FAI. Minimally invasive treatment of the hip under arthroscopy can achieve good early- and medium-term effectiveness, and has certain advantages in repairing and maintaining the integrity of the glenoid lip and suturing/compression joint capsule. However, the long-term effectiveness needs to be further followed up to determine. The timing of surgery, intraoperative bone edge depth polishing, and joint capsule suturing/compression techniques also need to be further explored.