COLORADO SPRINGS, Colo. — For patients with femoroacetabular impingement, surgical treatment of labral pathology with femoral osteoplasty yielded better long-term outcomes and survivorship compared with arthroscopy alone.
“So, how important is femoral correction in FAI?” Jeffrey J. Nepple, MD, MS, said in his presentation at the American Orthopaedic Society for Sports Medicine Annual Meeting. “A large body of literature supports the association of CAM-type [FAI] with arthritis, but we have limited data connecting our surgeries to changing the natural history of this disease,” he added.
Nepple and colleagues performed a retrospective comparative study that analyzed clinical outcomes and survivorship in patients with isolated CAM-type FAI at a minimum of 15 years. According the abstract, 23 patients underwent surgical treatment of labral pathology with femoral osteoplasty (mean follow-up of 16 years) and 17 patients underwent surgical treatment of labral pathology without femoral osteoplasty (mean follow-up of 19.7 years). Patients with pincer or combined CAM-pincer morphologies were excluded from the study, and clinical outcomes were assessed using the modified Harris hip score (mHHS) and Kaplan-Meier survival curve.
Jeffrey J. Nepple
Kaplan-Meier analysis revealed the femoral osteoplasty cohort had greater 15-year THA-free survivorship rates (78% vs. 41%) and reoperation-free survivorship rates (78% vs. 29%) compared with patients who did not receive femoral osteoplasty. The femoral osteoplasty cohort also had a higher final mHHS (82.7 vs. 64.7) and mHHS improvement (18.4 vs. 6.1) compared with patients who did not receive femoral osteoplasty. Nepple also noted the femoral osteoplasty cohort had a lower rate of THA conversion and overall reoperation compared with patients who did not receive femoral osteoplasty.
“In summary, femoral osteoplasty appears to play a substantial role in long-term outcomes of FAI surgery – increasing the rate of THA-free survivorship. These effects aren’t seen in the first 5 years after surgery,” Nepple said. “Future longer prospective studies remain important to support the ability of our surgeries to be truly hip preserving and alter the natural history of FAI,” he concluded.