Open Surgical Dislocation versus Arthroscopy for Femoroacetabular Impingement: A Comparison of Clinical Outcomes
Authors: Botser IB, Smith TW Jr, Nasser R, Domb BG
DOI: 10.1016/j.arthro.2010.11.008
Background
Femoroacetabular impingement (FAI) can be managed surgically through arthroscopy, open surgical dislocation, or a combination of both. Choosing the optimal approach depends on balancing functional outcomes, complication risk, and patient goals.
Methods
Systematic review of 26 studies including 1,462 hips. The analysis compared functional outcomes, complication rates, and return-to-sport rates across surgical techniques.
Key Findings
- Arthroscopy was used in 62% of cases and resulted in the highest average improvement in hip scores (26.4 points).
- Open and combined approaches were more likely to involve labral repair.
- Complication rates were lowest with arthroscopy (1.7%) compared to open (9.2%) and combined (16%).
- Athletes had higher return-to-sport rates following arthroscopy.
Conclusions
All three surgical approaches improved patient outcomes. However, arthroscopy demonstrated advantages in recovery time, complication profile, and functional return, particularly in active populations.
What This Means for Providers
Arthroscopy should be considered the preferred approach for treating FAI in most patients, particularly athletes or active individuals, due to its favorable safety profile, faster recovery, and excellent functional outcomes. Open or combined procedures may still be appropriate in select cases requiring more extensive correction or labral work, but carry higher complication risks.