title: Isolated Acetabuloplasty and Labral Repair for Combined-Type Femoroacetabular Impingement: Are We Doing Too Much?
abstract: OBJECTIVE
  To evaluate patient outcomes after isolated arthroscopic volumetric acetabular osteoplasty and labral repair for the treatment of patients with combined femoroacetabular impingement (FAI) lesions.
  
  
  METHODS
  A review of a prospectively collected registry identified 86 patients (106 hips) with an average age of 38.1 years (range, 17-59 years) with combined-type FAI that underwent isolated acetabular osteoplasty and labral repair. Preoperative α-angle, degree of radiographic degenerative changes, and presence of a crossover sign were recorded. Clinical outcomes were assessed with the modified Harris Hip Score (mHHS), International Hip Outcome Tool-12 (iHOT-12), Hip Outcome Score Sport-Specific Subscale (HOS-SSS), and patient satisfaction score (out of 10) at a minimum 2-year follow-up.
  
  
  RESULTS
  Clinical follow-up was obtained at a mean follow-up of 37.2 months (range, 27.9-79.2 months). Patients with Tönnis grade 0 and I findings had significantly higher mHHS (83.5 vs 71.5, P = .01), HOS-SSS (81.3 vs 59.9, P = .02), and iHOT-12 scores (71.1 vs 58.8, P = .04) compared to patients with Tonnis grade II changes. However, patient satisfaction scores (8.0 vs 7.2, P = .45) were no different. No significant difference was noted between unilateral and bilateral hip patient outcome scores. Patient age and preoperative α-angles did not correlate with any outcome scores (all R2<0.05). There were no cases of revision surgery or progression to arthroplasty.
  
  
  CONCLUSIONS
  Isolated acetabular decompression may adequately address the underlying impingement in combined-type FAI while avoiding the risks associated with femoral-sided decompression. Good to excellent patient-reported outcomes and satisfaction scores were noted with significantly higher scores in patients with minimal arthritic change. Patient age and preoperative α-angle had less effect on postoperative outcomes.
  
  
  METHODS
  Level IV, therapeutic case series.
authors.affiliation: Northwestern University, Feinberg School of Medicine, Chicago, Illinois, U.S.A.. Electronic address: vehniah.tjong@northwestern.edu.
authors.forename: Vehniah K
authors.initials: VK
authors.lastname: Tjong
authors.affiliation: Northwestern University, Feinberg School of Medicine, Chicago, Illinois, U.S.A.
authors.forename: Mustafa M
authors.initials: MM
authors.lastname: Gombera
authors.affiliation: Northwestern University, Feinberg School of Medicine, Chicago, Illinois, U.S.A.
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Kahlenberg
authors.affiliation: Northwestern University, Feinberg School of Medicine, Chicago, Illinois, U.S.A.
authors.forename: Ronak M
authors.initials: RM
authors.lastname: Patel
authors.affiliation: Northwestern University, Feinberg School of Medicine, Chicago, Illinois, U.S.A.
authors.forename: Brian
authors.initials: B
authors.lastname: Han
authors.affiliation: Northwestern University, Feinberg School of Medicine, Chicago, Illinois, U.S.A.
authors.forename: Prashant
authors.initials: P
authors.lastname: Deshmane
authors.affiliation: Northwestern University, Feinberg School of Medicine, Chicago, Illinois, U.S.A.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Terry
mesh_terms: D065526:Acetabuloplasty / Q000379:methods* / Q000534:rehabilitation; D000077:Acetabulum / Q000000981:diagnostic imaging / Q000601:surgery; D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D001182:Arthroscopy / Q000379:methods; D019299:Decompression, Surgical / Q000379:methods; D005260:Female; D057925:Femoracetabular Impingement / Q000000981:diagnostic imaging / Q000534:rehabilitation / Q000601:surgery*; D005500:Follow-Up Studies; D006621:Hip Joint / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011859:Radiography; D012042:Registries; D012086:Reoperation; D016896:Treatment Outcome; D055815:Young Adult