Surgical Dislocation of the Hip Versus Arthroscopic Treatment of Femoroacetabular Impingement: A Prospective Matched-Pair Study with Average 2-Year Follow-up
Authors: Domb BG, Stake CE, Botser IB, Jackson TJ
DOI: https://doi.org/10.1016/j.arthro.2013.06.010
Purpose
To compare functional outcomes between open surgical dislocation and arthroscopic treatment of femoroacetabular impingement (FAI) in young patients using a prospective, matched-pair study design.
Methods
10 patients underwent surgical dislocation matched 1:2 with 20 patients treated arthroscopically. All patients were ≤30 years old with an average follow-up of ~25 months. Outcomes measured included patient-reported outcome scores and radiographic alpha angles.
Key Findings
- Both groups demonstrated significant improvements postoperatively.
- Arthroscopy patients achieved superior results in sport-specific activities (Hip Outcome Score–Sport-Specific Subscale: 42.8 vs. 23.5, p = .047) and Non-Arthritic Hip Score (94.2 vs. 85.7, p = .01) at 2 years.
Conclusion
Arthroscopic treatment of FAI provides better functional improvement in sports-related activities than surgical dislocation at two years, while both approaches are effective.
What Does This Mean for Providers?
- Arthroscopy should be considered the first-line surgical approach for young patients with FAI due to less invasiveness and superior functional outcomes, particularly in athletic populations.
- Surgical dislocation remains an option for complex deformities but may be associated with longer recovery.
- Patient selection and surgeon expertise remain key factors in optimizing outcomes.