ePoster #741 - ISHA Annual Scientific Meeting 2016
Long Term Outcome Of Arthroscopic Cam Resection For Patients Over 60 Years Of Age With Preserved Joint Space
Suenghwan Jo, MD, PhD, Gwangju SOUTH KOREA
John M. O'Donnell, MBBS, FRACS, FAOrthA, Hawthorn, VIC AUSTRALIA
Hip Arthroscopy Australia, Melbourne, VIC, AUSTRALIA
FDA Status Cleared
Summary: Arthroscopic osteochondroplasty for cam impingement in older age group can provide long term benefit but the initial chondral defect of acetabulum or femoral head is a relevant risk factor leading to poor outcome.
Introduction : Arthroscopic osteochondroplasty is regarded as one of the most efficient method to treat cam type femoroacetabular impingement (FAI) of the hip. However, there are limited knowledge on the long term outcome of arthroscopic osteochondroplasty in the older population. This study aims to find out the minimum 5 year outcome of arthroscopic cam resection in the patient older than 60 years with preserved joint space.
Material and methods : The study comprises of 30 patients with mean age of 65.8 years (range 60 to 78 years) who had arthroscopic femoral osteochonroplasty due to cam type FAI between August 2005 and Noveber 2009. Patients with advanced osteoarthritis (Grade 2 or 3 according to Tonnis and Heinecke), pincer type FAI, bilateral FAI, history of previous hip operations or metabolic hip diseases were excluded from the study. The patients were followed for mean of 85 months (range 61 to 112 months). All patients had preserved joint space (wider than 3mm) at the time of the surgery. The clinical outcomes were measured using modified Harris hip score (mHHS), and non-arthritic hip score (NAHS) and the results were compared with the preoperative scores.
Results : Nine patients had reoperated with hip arthroplasty at mean of 17 months while 4 patients required additional hip arthroscopy due to the similar preoperative symptoms at mean of 20 months from the index operation. Eight out of nine patients who had subsequent hip arthroplasty were found to have chondral defect at acetabulum or at femoral head at the time of the surgery. Of the 17 patients who did not go through additional operation, the mean mHHS increase from 62.0 to 81.7 while mean NAHS improved from 61.0 to 86.7.
Conclusion : The study indicates that the arthroscopic osteochondroplasty to treat cam impingement of the hip in older age group can be beneficial. However, the patients with apparent acetabular or femoral head chondral defect are likely to develop advanced hip arthritis indicating the initial condition of the central compartment cartilage is the important prognostic factor leading to poor outcome.