Objective To investigate the effectiveness of hip arthroscopy in the treatment of patients with femoroacetabular impingement (FAI) syndrome combined with ligamentum teres injury. Methods A retrospective analysis was conducted on 23 patients (23 hips) with Cam-type FAI syndrome combined with ligamentum teres injury who met the selection criteria between April 2022 and May 2024. The cohort included 12 males and 11 females, with a mean age of 29.16 years (range, 16-57 years). According to T?nnis classification, there were 5 cases of grade 0, 10 cases of grade Ⅰ, and 8 cases of grade Ⅱ in hip osteoarthritis. The disease duration ranged from 6 to 24 months, with an average of 12 months. Under hip arthroscopy, hypertrophic synovium and the damaged ligamentum teres were debrided, while the torn labrum and cartilage were repaired, and femoral head-neck osteoplasty was performed to eliminate impingement, restore the normal morphology of the acetabulum and femoral head-neck, and suture the joint capsule. Acetabular lateral center-edge angle (LCEA) and α angle (reflecting the degree of non-sphericity at the femoral head-neck junction) were measured before and after operation, and the modified Harris hip score (mHHS), the International Hip Outcome Tool-12 (IHOT-12), and the visual analogue scale (VAS) score for pain were evaluated. ResultsThe operation was successfully completed in all patients. The incisions healed by first intention after operation, and there was no perioperative complications such as iatrogenic cartilage injury, fracture, infection, neurovascular traction injury, or lower extremity venous thrombosis. All the 23 patients were followed up 12-24 months, with an average of 14.6 months. The pain of hip joint significantly relieved, and the function of hip joint improved; no complication such as joint stiffness, joint instability, and osteonecrosis of the femoral head occurred. The α angle, VAS score, mHHS score, and IHOT-12 score at last follow-up were significantly better than those before operation (P<0.05); there was no significant difference in LCEA compared to preoperative value (P>0.05). Conclusion Hip arthroscopy is a safe and effective treatment for patients with FAI syndrome combined with ligamentum teres injury, which can achieve satisfactory effectiveness.
ObjectiveTo evaluate the short-term effectiveness of arthroscopic surgery combined with direct anterior approach for hip diseases.MethodsA retrospective study was performed on 23 cases with hip diseases (23 hips), who were treated with the arthroscopic surgery combined with direct anterior approach, between January 2015 and December 2016. There were 9 males and 14 females, aged from 27 to 49 years (mean, 38.6 years). There were 11 cases of posterior dislocation of the hip associated with femoral head fracture (Pipkin typeⅠ) and 7 cases of femoral neck fracture (Garden type Ⅳ). And the interval between injury and operation was 2-8 days (mean, 4.3 days). Five cases were osteonecrosis of femoral head at precollapse stage which were rated as stageⅡA according to Association Research Circulation Osseous (ARCO) classification system. The disease duration was 3-8 months (mean, 5.9 months). The preoperative Harris hip score, Oxford Hip Score (OHS), Postel score, and visual analogue scale (VAS) were 57.3±8.2, 11.2±3.6, 3.2±1.5, and 7.2±1.3, respectively.ResultsAll the wounds healed primarily. Lateral femoral nerve injury occurred in 3 cases. All patients were followed up 8-19 months (mean, 15.6 months). Bone union achieved in all patients after 14-19 weeks (mean, 15.8 weeks) and no secondary osteoarthritis or heterotopic ossification occurred. At last follow-up, the Harris hip score (92.5±5.3), OHS (36.5±5.9), and Postel score (14.2±2.6) were significantly higher than preoperative scores (t=45.274, P=0.000; t=36.586, P=0.000; t=32.486, P=0.000), and VAS score (1.8±0.9) was significantly lower than preoperative score (t=21.314, P=0.000).ConclusionArthroscopic surgery combined with direct anterior approach for hip diseases can effectively relieve pain, improve hip function, and obtain the satisfactory short-term effectiveness.
