The Management of Labral Tears and Femoroacetabular Impingement of the Hip in the Young, Active Patient

Asheesh Bedi, Neal Chen, William Robertson, Bryan T. Kelly

Research output: Contribution to journalArticle

168 Scopus citations

Abstract

Purpose: The purpose of this systematic review was to determine (1) the quality of the literature assessing outcomes after surgical treatment of labral tears and femoroacetabular impingement (FAI), (2) patient satisfaction after open or arthroscopic intervention, and (3) differences in outcome with open or arthroscopic approaches. Methods: Computerized literature databases were searched to identify relevant articles from January 1980 to May 2008. Studies were eligible for inclusion if they had a level I, II, III, or IV study design and if the patient population had a labral tear and/or FAI as the major diagnosis. Patients with severe pre-existing osteoarthritis or acetabular dysplasia were excluded. Results: Of the 19 articles with reported outcomes after surgery, none used a prospective study design and only 1 met the criteria for level III basis of evidence. Open surgical dislocation with labral debridement and osteoplasty is successful, with a good correlation between patient satisfaction and favorable outcome scores. The studies reviewed support that 65% to 85% of patients will be satisfied with their outcome at a mean of 40 months after surgery. A common finding in all series, however, was an increased incidence of failure among patients with substantial pre-existing osteoarthritis. Arthroscopic treatment of labral tears is also effective, with 67% to 100% of patients being satisfied with their outcomes. Conclusions: The quality of literature reporting outcomes of surgical intervention for labral tears and FAI is limited. Although open surgical dislocation with osteoplasty is the historical gold standard, the scientific data do not show that open techniques have outcomes superior to arthroscopic techniques. Level of Evidence: Level IV, systematic review.

Original languageEnglish (US)
Pages (from-to)1135-1145
Number of pages11
JournalArthroscopy - Journal of Arthroscopic and Related Surgery
Volume24
Issue number10
DOIs
StatePublished - Oct 1 2008

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Keywords

  • Femoroacetabular impingement
  • Labral tear
  • Surgical dislocation
  • Systematic review

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

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