Quality of life following femoral head-neck osteochondroplasty for femoroacetabular impingement.
BACKGROUND
Femoroacetabular impingement has been recently described as a common cause of hip pain and labral tears in young adults. We evaluated the early clinical results and quality of life after osteochondroplasty of the femoral head-neck junction for the treatment of femoroacetabular impingement.


METHODS
Thirty-seven hips in thirty-four patients with persistent hip pain and a mean age of 40.5 years underwent surgical dislocation of the hip and osteochondroplasty of the femoral head-neck junction for the treatment of camtype femoroacetabular impingement. All of the patients had had preoperative evidence of pathological changes in the labrum on imaging. The clinical course and the quality of life were assessed postoperatively.


RESULTS
The mean score on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) increased from 61.2 points preoperatively to 81.4 points at a mean of 3.1 years postoperatively (p < 0.001), the mean University of California at Los Angeles (UCLA) activity score increased from 4.8 to 7.5 points (p < 0.001), the mean Short Form-12 (SF-12) physical component score increased from 37.3 to 45.6 points (p < 0.001), and the mean SF-12 mental component score increased from 46.4 to 51.2 points (p = 0.031). None of the hips underwent additional reconstructive surgery. There were no cases of osteonecrosis. Nine patients underwent screw removal from the greater trochanter because of persistent bursitis. Six of the thirty-four patients were dissatisfied with the outcome.


CONCLUSIONS
Cam-type femoroacetabular impingement is associated with insufficient concavity at the anterolateral head-neck junction and with pathological changes in the labrum. Osteochondroplasty of the femoral head-neck junction following surgical dislocation of the hip joint is safe and effective and can provide a significant improvement in the overall quality of life of most patients.


METHODS
Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.
Beaulé
Paul E
PE
Division of Orthopaedic Surgery, University of Ottawa, Ottawa Hospital General Campus, 501 Smyth Road, Suite 5004, Ottawa, ON K1H 8L6, Canada.
Le Duff
Michel J
MJ
Zaragoza
Edward
E
D000077:Acetabulum / Q000601:surgery*; D000328:Adult; D002358:Cartilage, Articular / Q000601:surgery*; D005260:Female; D005270:Femur Head / Q000601:surgery*; D005272:Femur Neck / Q000601:surgery*; D006621:Hip Joint / Q000601:surgery*; D006801:Humans; D007592:Joint Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods; D011788:Quality of Life