Arthroscopy: The Journal of Arthroscopic & Related Surgery
Systematic ReviewThe Management of Labral Tears and Femoroacetabular Impingement of the Hip in the Young, Active Patient
Section snippets
Methods
We searched the Medline, EMBASE, and Cochrane computerized literature databases for articles from January 1980 to May 2008 containing the following terms: FAI, hip, surgical dislocation, arthroscopy, labrum, labral tear, and outcome. All studies from the previously mentioned searches were reviewed. Reference lists from the articles were retrieved to identify any additional studies of interest. Studies were eligible for inclusion if they met the following criteria: (1) they were in English, (2)
Open Surgical Series
A summary of the outcomes after open surgical dislocation for FAI and labral tears is shown in Table 1. The open surgical series collectively assessed outcomes in 197 patients with a mean follow-up of 40 months. A range of 65% to 94% good to excellent outcomes was reported. The failure rate, as defined by a dissatisfied patient and/or conversion to total hip arthroplasty, ranged from 4% to 30%.
Beck et al.25 were the first to report midterm results of open surgical dislocation and osteoplasty
Discussion
Improved attention to careful examination of the hip in combination with advances in magnetic resonance imaging have substantially improved our ability to detect early degenerative changes previously not detected on conventional radiographs.1, 2, 3, 4, 5, 43 In particular, labral tears have been diagnosed with increasing frequency and have been recognized to be 1 of the factors contributing to osteoarthritis of the hip.14, 15, 22 Recent work by Ganz et al.26 identified morphologic abnormalities
Conclusions
The quality of the literature assessing clinical outcomes after open or arthroscopic treatment of FAI and labral pathology is limited. On the basis of the studies published to date, our hypothesis that arthroscopic techniques are as effective as open surgical techniques in achieving satisfactory clinical outcomes in the treatment of FAI and labral pathology was supported. Although open surgical dislocation with osteoplasty is the historical gold standard, the scientific data do not show that
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The authors report no conflict of interest.