ePoster #704 - ISHA Annual Scientific Meeting 2016

Cam Recurrence And Functional Outcomes Following Arthroscopic Femoral Osteoplasty In Adolescents

Ryan M. Degen, MD, FRCSC, New York, NY UNITED STATES
Stephanie Watson Mayer, MD, Aurora, CO UNITED STATES
Kara Fields, MS, New York, NY UNITED STATES
Struan H. Coleman, MD, PhD, New York, NY UNITED STATES
Bryan Talmadge Kelly, MD, New York, NY UNITED STATES
Danyal H. Nawabi, MD, FRCS(Orth), New York, NY UNITED STATES

Hospital for Special Surgery, New York, New York, UNITED STATES

FDA Status Not Applicable

Summary: This article reviews the incidence of cam deformity recurrence in adolescent patients following femoral osteoplasty

Abstract:
Background:
The cam deformity in femoroacetabular impingement (FAI) is theorized to form in response to high activity levels during adolescence, particularly with participation in cutting and pivoting sports such as soccer, football and ice hockey. Consequently, concern exists over the possibility of cam recurrence following femoral osteoplasty in adolescents.
Purpose
(1)To report the radiographic recurrence rate of the cam deformity in a cohort of adolescent patients following arthroscopic femoral osteoplasty for FAI.
(2) To report patient-reported outcome measures (PROM) compared with a matched control cohort of non-adolescent patients.
Methods:
From 2010 to 2013, 45 patients (63 hips) with an average age of 15.7 years (range 13-17) were identified. Mean clinical follow-up was 25.2 months (range 11.4-46.8). Twenty-seven patients (60%) were male. A subgroup of 24 patients (30 hips) had minimum 2-year radiographs available for review. A control cohort of 320 patients (385 hips) meeting these same criteria, with the exception of age (mean 30.2, range 18-59), was selected as our non-adolescent group. Demographics, radiographic data and clinical outcome scores were collected and reviewed.
Results:
Alpha angle improved from 55.4±12.4° pre-operatively to 38.7±5.2° at 6-weeks post-operatively (p<0.001). At 2 years, the alpha angle remained at 39.1±11.5° which did not differ from 6-week measurements (p=0.38). One patient (1/30) demonstrated radiographic evidence of cam recurrence on 2-year radiographs. There were statistically significant improvements on immediate and final post-operative PROM (mHHS, HOS-ADL, HOS-SSS and iHOT-33, p<0.001). Comparisons with a non-adolescent control cohort of 320 patients (385 hips) did not identify any statistically significant differences in outcome scores (p=0.107). Two patients (3.2%) in the adolescent group required revision surgery, compared with 15 patients (3.9%) in the control group.
Conclusions:
Radiographic recurrence of the cam deformity was rare (3.3%) among adolescent patients following femoral osteoplasty at 2-year follow-up, with comparable improvements in PROM at final follow-up.