What happens to people who have surgery to reshape the hip for a problem called femoroacetabular impingement? That would describe me -- I had the surgery done last year and just wondering if it will hold.
Surgery for femoroacetabular impingement (FAI) has been reported "successful" but results are only available for the early or short-term postoperative period. A recent study from Switzerland has some information that might be helpful in answering your question.
They followed a group of 185 patients treated with open hip surgery for this problem. The follow-up period was at least five years. The measures of "success" included hip range-of-motion, X-ray results, patient satisfaction, and activity level. The need for further surgery (and especially conversion to a total hip replacement) was also recorded.
Femoroacetabular impingement (FAI) causes abnormal contact between the femoral neck and the acetabular (hip socket) rim. Pinching of the labrum (cartilage around the edge of the socket causes damage to the cartilage and to the bone. The result can be a stiff, painful hip with loss of motion and function.
One treatment used for this condition is surgery to alter the anatomic abnormalities that contribute to the problem. For the patients in this study, the hip was surgically dislocated, the tissue was trimmed, and the bone was reshaped to eliminate the abnormal contact that causes this type of pinching.
The goals of surgery are to return the patients to full, normal activities without pain and to prevent (or at least slow down) hip osteoarthritis. Most of the patients with FAI are young, athletes. Patient satisfaction depends on good-to-excellent long-term results. This study provides mid-term results with the intention of following these patients into the long-term.
Outcomes of activity and function were measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the SF-12 Physical and Mental Scores, and the University of California - Los Angeles (UCLA) activity scale. Before and after measurements showed improvement in hip motion and function. Eighty-three per cent (83%) of the group said their hips were normal (or near normal) in the follow-up period.
Long-term follow-up will be able to determine whether open surgery with surgical dislocation to correct FAI helps prevent degeneration of the joint. Slowing the formation of osteoarthritis would be an acceptable outcome as well. Finding ways to prevent the need for hip replacement in young, active individuals with FAI will be another focus of future studies.
Florian D. Naal, MD, et al. Midterm Results of Surgical Hip Dislocation for the Treatment of Femoroacetabular Impingement. In The American Journal of Sports Medicine. July 2012. Vol. 40. No. 7. Pp. 1501-1510.
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