Titre :

Treatment of femoroacetabular impingement by arthroscopy versus anterior mini-open approach: Case-control study of a continuous series of 91 cases at a mean 4.6 years’ follow-up

Auteur(s) :

Martinot, Pierre [Auteur]
Hôpital Roger Salengro [Lille]
Université Lille Nord (France)
Trouillez, Teddy [Auteur]
Université de Lille
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Dartus, Julien [Auteur]
Université de Lille
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Putman, Sophie [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Girard, Julien [Auteur]
Unité de Recherche Pluridisciplinaire Sport, Santé, Société (URePSSS) - ULR 7369
Migaud, Henri [Auteur]
Marrow Adiposity & Bone Lab (MABLab) - ULR 4490
Physiopathologie des Maladies Osseuses Inflammatoires (PMOI) - ULR 4490

Titre de la revue :

Orthopaedics & Traumatology. Surgery & Research

Nom court de la revue :

Orthopaedics & Traumatology: Surgery & Research

Numéro :

106

Pagination :

1575-1580

Éditeur :

Elsevier

Date de publication :

2020-12

ISSN :

1877-0568

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

Femoroacetabular impingement is a frequent cause of hip pain, and can be managed by conservative surgery. Many studies assessed postoperative course, but none compared operative techniques within a given population. We ...
Lire la suite >Femoroacetabular impingement is a frequent cause of hip pain, and can be managed by conservative surgery. Many studies assessed postoperative course, but none compared operative techniques within a given population. We therefore conducted a retrospective case-control study comparing the minimally invasive anterior Hueter approach versus arthroscopy, assessing difference in 1) functional gain and 2) complications and 3) analyzing the impact of labral or cartilage lesions on functional scores. Hypothesis Clinical results do not differ between the mini-open and arthroscopic approach. Material and method Between 2007 and 2018, 91 hips in 84 patients were treated for femoroacetabular impingement: 69/91 (75.8%) cam effect, 6/91 pincer effect (6.6%) and 16/91 mixed (17.6%). Fifty-five were treated by arthroscopy and 36 by the Hueter mini-open approach. There were 20 female and 71 male hips. Mean age at surgery was 32 years (range, 17–55 years). Potential predictive factors comprised Nötzli alpha angle, labral/cartilage lesion and type of surgery. Results Mean follow-up was 4.6 years (range, 1–16 years), with no loss to follow-up. The arthroscopy and Hueter groups showed no differences in functional improvement on Oxford-12 score (gain, −6.7 ± 5.9 versus −6.2 ± 8.1 (p = 0.73), Postel Merle d’Aubigné (PMA) score (gain, 1.3 ± 1 versus 1.1 ± 0.9; p = 0.41), operative time (75 versus 67 min; p = 0.16), or alpha angle correction (−10.9 ± 12.9 versus −9.8 ± 7.1; p = 0.22). Complications did not differ: 1/55 severe complications after arthroscopy (1 definitive femoral nerve palsy) versus 4/36 non-severe complications after Hueter (3 cases of dysesthesia in the lateral cutaneous nerve of the thigh, 1 rectus femoris enthesopathy) (p = 0.15). Labral lesions (37/91) did not affect clinical outcome: gain, 1.2 ± 1 versus 1.3 ± 0.9 on PMA (p = 0.514) and −7.3 ± 6 versus −6 ± 7.3 on Oxford-12 (p = 0.366). Cartilage lesions (27/91) were associated with poorer outcome on PMA (gain, 1 ± 1.1 versus 1.3 ± 0.9; p = 002) but not on Oxford-12 (gain, −6.1 ± 7.3 versus −6.7 ± 6.6; p = 0.288). Conclusion Impingement correction by the minimally invasive anterior Hueter approach gave clinical results comparable to those of hip arthroscopy in terms of Oxford and PMA scores, alpha angle correction, operative time and complications. Cartilage lesions were associated with poorer clinical results.Lire moins >

Langue :

Anglais

Audience :

Internationale

Vulgarisation :

Non

Établissement(s) :

CHU Lille
Univ. Artois
Univ. Littoral Côte d’Opale
Université de Lille

Collections :

• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
• Unité de Recherche Pluridisciplinaire Sport, Santé, Société (URePSSS) - ULR 7369

Date de dépôt :

2021-12-08T09:53:51Z
2024-02-07T09:38:36Z