title: [Resection at symptomatic cam impingement. Use of a minimally invasive antero-lateral approach].
abstract: BACKGROUND
  Surgical treatment of femoroacetabular impingement (FAI) is nowadays achieved by either open surgical hip dislocation or hip arthroscopy. However, drawbacks of both procedures include the invasiveness of the open procedure and a high learning curve to successfully perform arthroscopic treatment. In our institution, we established a minimally invasive, arthroscopically assisted, antero-lateral approach for the correction of cam type FAI.
  
  
  OBJECTIVE
  The goal of the study was to describe the surgical technique and highlight the short-term clinical outcome in a consecutive series of patients operated between 2011 and 2014 in our institution.
  
  
  METHODS
  In total, 77 patients were included in this study. The patients were allocated to two groups (Toennis = 0: Group I; Toennis 1 and 2: Group II). Clinical and radiographic follow up was obtained at 6 and 12 weeks postoperatively. Clinical outcome was assessed using the Hip-Outcome-Score.
  
  
  RESULTS
  The mean age of patients in Group I was 25 (16-48) years and in Group II 38 (17-50) years respectively. Internal rotation (IR) in 90° flexion increased by 11 degrees from pre- to postoperatively in Group I (p < 0.001) and by 14° in Group II (p < 0.001). The Hip Outcome Score revealed the ability to perform sports with reduced pain at three months follow up. Subjectively, all patients benefitted in terms of pain and hip function in both groups (p < 0.001). There were no complications with long-term morbidity during the perioperative course.
  
  
  CONCLUSIONS
  Arthroscopically assisted cam resection using a minimally invasive anterolateral approach is a safe technique for the treatment of FAI. At short term follow up, nearly all operated patients seem to benefit in terms of pain and hip function. The influence of progression of osteoarthritis still has to be shown.
authors.affiliation: Klinik für Orthopädie, Traumatologie und Sportmedizin Spital STS AG Thun, Krankenhausstrasse 12, 3600, Thun, Schweiz. Johannes.weihs@gmx.de.
authors.forename: Johannes
authors.initials: J
authors.lastname: Weihs
authors.affiliation: Klinik für Orthopädie, Traumatologie und Sportmedizin Spital STS AG Thun, Krankenhausstrasse 12, 3600, Thun, Schweiz.
authors.forename: P
authors.initials: P
authors.lastname: Scacchi
authors.affiliation: Klinik für Orthopädie, Traumatologie und Sportmedizin Spital STS AG Thun, Krankenhausstrasse 12, 3600, Thun, Schweiz.
authors.forename: R
authors.initials: R
authors.lastname: Hess
authors.affiliation: Dept. of Orthopaedic Surgery, Fiona Stanley Hospital, 102-108 Murdoch Dr, 6150, Murdoch, WA, Australien.
authors.forename: C E
authors.initials: CE
authors.lastname: Albers
mesh_terms: D000293:Adolescent; D000328:Adult; D018771:Arthralgia / Q000175:diagnosis / Q000517:prevention & control*; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D057925:Femoracetabular Impingement / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D016059:Range of Motion, Articular; D016896:Treatment Outcome; D055815:Young Adult
keywords: Arthroscopic surgery; Femoroacetabular impingement; Hip displacement; Joint flexibility; Pain