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EARLY EXPERIENCE AND RESULTS FOR 148 SURGICAL HIP DISLOCATION PERFORMED FOR IMPINGEMENT

Royal Cornwall Hospital

Introduction: The open treatment of hip impingement is now a well-recognised technique with numerous publications about pathogenesis and surgical technique. There are very few publications of very small series discussing surgical results.

We present the results of 148 hips at a mean follow-up of 20 months (range 4 – 55).

Methods: This is a two surgeon series of sequential patients including the early learning curve. Patients were treated for impingement through a Ganz trochanteric osteotomy and open surgical hip dislocation. Patient data, operative findings and methods, complication and clinical follow up were recorded as a prospective audit and include Oxford and McCarthy Non Arthritic Hip scores.

Results: The patient demographics are as follows:

• 141 patients, 148 hips.
  
• Average age 35, range 10–65 years
  
• Ratio Male to Female 73:75
  
• All patients underwent femoral osteochondroplasty.
  
• 60% of cases had the labrum detached, acetabular rim recession and labral repair with bone anchors.
  
• 3 patients had the labrum reconstructed with the ligamentum teres autograft.
  
• We have had 9 failures (6%) as defined by revision to arthroplasty.
  
• 2 hips underwent successful revision open surgery for inadequately treated posterior impingement.
  
• 3 patients required arthroscopy after open surgery (2 of whom are now pain free).
  
• 7 further patients have persistent groin pain but not required further intervention.
  

We have had the following complications: 4 trochanteric non unions requiring revision fixation, 2 deep vein thrombosis, 2 haematomas, 1 superficial infection, no deep Infections.

Life table survival curve with revision to arthroplasty defined as failure.

Discussion: The early to midterm results of this innovative procedure are encouraging even when including the decision making and surgical technique learning curves. We will present the hip scores and discuss the failures in detail to warn others embarking on this surgery which cases are more likely to lead to unsatisfactory outcomes.

Correspondence should be addressed to Mr Peter Howard, Editorial Secretary, BHS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE, England.