Open Surgical Dislocation Versus Arthroscopic Treatment of Femoroacetabular Impingement

It is unclear if open surgical dislocation or arthroscopy of the hip is superior for the treatment of femoroacetabular impingement (FAI).

We prospectively compared the clinical results of these 2 surgical methods performed by a single surgeon. Five patients met the inclusion criteria for the open surgical dislocation group and 18 for the arthroscopic group. Patient-reported scores, including the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score–Sport-Specific Subscale (HOS–SSS) and Hip Outcome Score–Activities of Daily Living (HOS–ADL) were used preoperatively, and at 3 months, 6 months, and 1 year postoperatively to compare the 2 groups. Average follow-up was 14.7 months (range, 12 to 25 months); both groups showed significant improvement in their postoperative scores compared with preoperative scores (P < .01). The arthroscopic group had better, earlier improvement at 3- and
6-month follow-up, with NAHS significantly better at 3 months (P < .0002). However, improvements were comparable between the 2 groups at 1 year.

Open surgical dislocation and arthroscopy are viable options for the treatment of FAI. The arthroscopic group demonstrated a trend toward faster recovery and quicker return to sports, but larger and longer-term studies are needed.