La luxation de hanche à ciel ouvert est plus efficace que l’arthroscopie pour le modelage de l’acétabulum dans le conflit acétabulaire - 07/11/19
Surgical hip dislocation is more powerful than arthroscopy for achieving high degrees of acetabular correction in pincer type impingement
, Maximilian Heilgemeier b, 1, Helen Anwander c, Martin Beck dAbstract |
Background |
With the development of hip arthroscopy (HA), a shift away from surgical hip dislocation(SHD) is becoming a noticeable reality. It was the aim of this study to examine whether SHD provides a benefit over HA regarding its corrective power in the treatment of femoroacetabular impingement (FAI).
Hypothesis |
It was hypothesized that SHD provides the more powerful tool for acetabular correction in FAI surgery compared to HA.
Method |
The examined cohort consisted of 85 hips of which 31 (36%) underwent a high degree of acetab-ular correction which was defined as a correction of >2 standard deviations from the population mean. A lateral center edge angle (LCE) correction >12∘or an acetabular index (AI) correction >8 were therefore considered to high correction. A logistic regression model was applied to determine factors influencing high correction in FAI surgery. Subsequent adjustment was performed using a multivariate model.
Results |
After adjusting for pre-operative acetabular orientation, SHD showed a pronounced influence on the likelihood of achieving the adequate degree of high acetabular correction (odds ratio (OR) 10.0confidence interval (C.I) 2.3 to 44.0, p=0.002). On the other hand, SHD showed no influence on femoral correction (p=n.s).
Conclusion |
Surgical hip dislocation is a powerful modality for achieving high degrees of acetabular correction in the situation of a femoroactabular conflict, being defined as an LCE correction of >12 or AI correction of >8. The reason for these results may be seen in the excellent exposure and the improved possibility of performing dynamic intra-operative examination to verify the results. The benefits are only limited to large acetabular correction. These findings should provide a helpful tool for decision making in clinical practise.
Level of evidence |
Level III retrospective cohort study.
Le texte complet de cet article est disponible en PDF.Keywords : Femoroacetabular impingement, FAI, Conflict, Impingement, Hip arthroscopy, Surgical hip dislocation
| ☆ | Cet article peut être consulté in extenso dans la version anglaise de la revue Orthopaedics & Traumatology: Surgery & Research sur Science Direct (sciencedirect.com) en utilisant le DOI ci-dessus. |
Vol 105 - N° 7
P. 871 - novembre 2019 Retour au numéro
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