Nepple JJ, et al. Article 44. Submitted to: American Orthopedic Society for Sports Medicine; July 13-17, 2022; Colorado Springs, Colorado.
Disclosures: Nepple does not report any relevant financial information.
COLORADO SPRINGS, Colo. – For patients with femoroacetabular impingement, surgical treatment of labral pathology with femoral osteoplasty has shown better long-term outcomes and improved survival compared to arthroscopy alone.
“So how important is femoral correction in FAI?” Jeffrey J. Nepple, MD, MS, said in his presentation at the annual meeting of the American Orthopedic Society for Sports Medicine. “A large number of publications support the CAM-like association [FAI] with arthritis, but we have limited data linking our surgeries to altering the natural history of this disease,” he added.
Nepple and colleagues performed a retrospective comparative study that analyzed clinical outcomes and survival in patients with isolated CAM-type CFA at at least 15 years. According to the abstract, 23 patients had surgical treatment of labral pathology with femoral osteoplasty (mean follow-up of 16 years) and 17 patients had surgical treatment of labral pathology without femoral osteoplasty (mean follow-up of 19.7 years). Patients with pinch or combined CAM pinch morphologies were excluded from the study and clinical outcomes were assessed using the modified Harris Hip Score (mHHS) and Kaplan-Meier Survival Curve .
Jeffrey J. Nepple
Kaplan-Meier analysis found that the femoral osteoplasty cohort had higher 15-year THA-free survival rates (78% versus 41%) and reoperation-free survival rates (78% versus 29%) than those patients who have not received femoral osteoplasty. The femoral osteoplasty cohort also had a final improvement in mHHS (82.7 versus 64.7) and mHHS (18.4 versus 6.1) compared to patients who did not receive femoral osteoplasty. Nepple also noted that the femoral osteoplasty cohort had a lower rate of THA conversion and overall reoperation compared to patients who did not receive femoral osteoplasty.
“In summary, femoral osteoplasty appears to play an important role in the long-term outcomes of FAI surgery – increasing PTH-free survival rate. These effects are not seen within the first 5 years after surgery,” said Nepple: “Future longer prospective studies remain important to support the ability of our surgeries to truly preserve the hip and alter the natural history of AIF,” he concluded.