title: Results of treatment of femoroacetabular impingement in adolescents with a surgical hip dislocation approach.
abstract: BACKGROUND
  The literature contains few studies of open treatment with an open surgical hip dislocation approach for treatment of femoroacetabular impingement (FAI) in adolescents. The average age and associated disorders in adolescents with FAI reveal a critical need to study younger patients whose hip disorder has not had time to progress.
  
  
  OBJECTIVE
  We assessed (1) how validated measures of patient-oriented assessment of hip function and quality of life change after surgical hip dislocation; (2) whether any patient-related or technique variables correlated with changes in the outcome scores; and (3) what the complications of treatment are and how many reoperations we performed on these patients.
  
  
  METHODS
  We retrospectively reviewed a consecutive series of 71 hips in adolescents younger than 21 years who underwent surgical hip dislocation for FAI. The final cohort consisted of 44 patients (52 hips) with a mean age of 16 years. We analyzed changes in outcome variables after surgical hip dislocation and recorded reoperations during the study period.
  
  
  RESULTS
  The minimum followup was 12 months (average, 27 months; range, 12-60 months). Modified Harris hip scores increased from a mean of 57.7 preoperatively to a mean of 85.8 postoperatively. Mean SF-12 scores increased from 42.3 to 50.6. Mean preoperative hip flexion increased from 97.5° to 106.2°. Mean internal rotation of the affected hip at 90° flexion increased from 18.19° to 34°.
  
  
  CONCLUSIONS
  Early results revealed improvements in hip function, patient quality of life, and ROM after surgical hip dislocation for the majority of this group of adolescents with FAI. However, 10% of the patients did not improve, and an additional 15% improved but still did not consider their hips good or excellent. This points toward the need for further studies in this population of patients.
authors: Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA. sinke@hss.edu
authors: Ernest L
authors: EL
authors: Sink
authors: Peter D
authors: PD
authors: Fabricant
authors: Zhaoxing
authors: Z
authors: Pan
authors: Michael R
authors: MR
authors: Dayton
authors: Eduardo
authors: E
authors: Novais
mesh_terms: D000293:Adolescent; D001696:Biomechanical Phenomena; D005260:Female; D057925:Femoracetabular Impingement / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D006617:Hip Dislocation; D006621:Hip Joint / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D019637:Orthopedic Procedures / Q000009:adverse effects; D011788:Quality of Life; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
references: Clin Orthop Relat Res. 2004 Jan;(418):67-73
references: 15043095
references: AJR Am J Roentgenol. 2007 Jun;188(6):1540-52
references: 17515374
references: Clin Orthop Relat Res. 2009 Mar;467(3):739-46
references: 19096902
references: J Pediatr Orthop. 2008 Dec;28(8):806-11
references: 19034169
references: Clin Orthop Relat Res. 2009 Mar;467(3):682-91
references: 19130159
references: Clin Orthop Relat Res. 2012 Aug;470(8):2220-6
references: 22528378
references: J Bone Joint Surg Br. 2001 Nov;83(8):1119-24
references: 11764423
references: J Arthroplasty. 2008 Feb;23(2):226-34
references: 18280417
references: Arthroscopy. 1994 Jun;10(3):275-80
references: 8086020
references: Arthroscopy. 2012 Sep;28(9):1255-61
references: 22560486
references: Clin Orthop Relat Res. 2003 Dec;(417):112-20
references: 14646708
references: Clin Orthop Relat Res. 2009 Mar;467(3):724-31
references: 19002743
references: J Bone Joint Surg Br. 1971 Aug;53(3):406-19
references: 5562367
references: J Bone Joint Surg Am. 2006 May;88(5):925-35
references: 16651565
references: Clin Orthop Relat Res. 2004 Jan;(418):61-6
references: 15043094
references: J Bone Joint Surg Am. 2007 Apr;89(4):773-9
references: 17403799
references: J Pediatr Orthop. 2006 May-Jun;26(3):281-5
references: 16670535
references: Clin Orthop Relat Res. 2004 Dec;(429):178-81
references: 15577484
references: Clin Orthop Relat Res. 2010 Feb;468(2):555-64
references: 19830504
references: Arthroscopy. 2011 Apr;27(4):486-92
references: 21444009
references: J Pediatr Orthop. 2008 Oct-Nov;28(7):705-10
references: 18812894
references: J Bone Joint Surg Br. 2009 Jan;91(1):16-23
references: 19091999
references: J Bone Joint Surg Am. 2006 Aug;88(8):1735-41
references: 16882895
references: Clin Orthop Relat Res. 2010 Mar;468(3):741-6
references: 19381742
references: Clin Orthop Relat Res. 2001 Jan;(382):232-40
references: 11153993
references: J Bone Joint Surg Am. 1973 Dec;55(8):1629-32
references: 4217797
references: Arthroscopy. 2008 May;24(5):540-6
references: 18442686
references: Clin Orthop Relat Res. 2010 Feb;468(2):504-10
references: 19885709
references: Ann Rheum Dis. 1970 Jan;29(1):15-31
references: 5416096
references: Iowa Orthop J. 2007;27:71-81
references: 17907434
references: Clin Orthop Relat Res. 2003 Aug;(413):201-7
references: 12897611
references: Clin Orthop Relat Res. 2009 Mar;467(3):769-74
references: 19082679
references: J Bone Joint Surg Am. 2010 Jul 21;92(8):1697-706
references: 20660232
references: Clin Orthop Relat Res. 2012 Jan;470(1):261-9
references: 21833657