title: Arthroscopic surgery for global versus focal pincer femoroacetabular impingement: are the outcomes different?
abstract: To determine outcomes from arthroscopic surgery for global pincer femoroacetabular impingement (FAI), a large multicenter prospective study investigating arthroscopic surgical outcomes was performed with minimum 2-year follow-up. Global (center-edge angle 40+ degrees) and Focal (center-edge angle 25-39 degrees) cohorts were based on pre-operative radiographs. Pre-operative and intra-operative findings, surgical procedures, post-operative nonarthritic hip score (NAHS) and satisfaction (5-point Likert scale), complications and conversion arthroplasties were compared. A nested case-control study was also performed. The Global cohort consisted of 15 patients (18 hips) of mean age 37.2 years. Pre-operative NAHS was 51.5 and 74.1 at 24+ months post-surgery. The change in NAHS was significant (P = 0.01). Mean satisfaction was 4.2. There was one total hip arthroplasty (THA) conversion (5.6%), no revision surgeries or complications. The Focal cohort consisted of 125 patients (129 hips) of mean age 39.8 years. Pre-operative NAHS was 54.8 and 77.8 at 24+ months post-surgery. The change in NAHS was significant (P < 0.0001). Mean satisfaction was 4.2. There were eight THA conversions (6.2%), three complications (2.3%) and two revision surgeries (1.5%). Cohort comparisons revealed no statistically significant difference in NAHS (P = 0.30), satisfaction (P = 0.92) or THA conversion rate (P = 0.91). The nested case-control study found mean post-operative change in NAHS was +22.2 and +20.4, respectively, at 24+ months (P = 0.76). Arthroscopic treatment of global pincer FAI is a safe and effective procedure. With outcomes comparable to those observed in the arthroscopic treatment of lesser focal deformities, arthroscopic surgery provides a less invasive option for the treatment of global pincer FAI.
authors.affiliation: 1. DISC Sports Medicine and Spine Centers, 13160 Mindanao Way #325, Marina del Rey, CA 90292, USA.
authors.forename: Dean K
authors.initials: DK
authors.lastname: Matsuda
authors.affiliation: 2. Jefferson Medical College, 1020 Walnut St, Philadelphia, PA 19107, USA.
authors.forename: Nikhil
authors.initials: N
authors.lastname: Gupta
authors.affiliation: 3. Kaiser Permanente Department of Research and Evaluation Pasadena, CA 91101, USA.
authors.forename: Raoul J
authors.initials: RJ
authors.lastname: Burchette
authors.affiliation: 4. Essentia Health, 3000 32nd Ave S Fargo, ND 58103, USA.
authors.forename: Bantoo
authors.initials: B
authors.lastname: Sehgal