Short-term results of surgical treatment of femoroacetabular impingement with open surgical dislocation of the femoral head

Gerasimov E.A., Morozova E.A., Korolev S.B., Gerasimov S.A.

Rationale: three methods are used for surgical correction of femoroacetabular impingement (FAI): surgical dislocation of the femoral head (Dann-Ganz operation), minimally invasive technique with direct anterior access (mini-open operation) and arthroscopic intervention.

The aim of the study was to evaluate the results of treatment of FAI with open surgical dislocation within 12 months after surgery.

Material and methods: a single-center, prospective, controlled, non-comparative study was conducted. From 2019 to 2021, 30 patients with FAI underwent open surgical dislocation. The results of treatment were evaluated using radiation research methods, magnetic resonance diagnostics and patient questionnaires using the iHOT12, HOOS, and VAS scales. Statistical data analysis was carried out using Microsoft Office Excel 2010 and Statistica 12 STATSOFT programs. To assess the normality of the data distribution, the Q–Q Plot and the Shapiro-Wilk criterion were used. Quantitative data are presented in the form of M±SD (where M is the average value, SD is the standard deviation). Qualitative data are presented in the form of P±σp (where P is the percentage, σp is the standard deviation of the percentage). Qualitative indicators were analyzed using conjugacy tables and the Pearson Chi-square criterion with the Yates correction. The data were considered statistically significant at p≤0.05.

Results: it was possible to achieve the angle-alpha indicators close to the target values. Analysis of gait biomechanics and scores on the iHOT12 and HOOS scales before and after surgery revealed no statistically significant differences. During the follow–up period, complications were revealed: avascular necrosis of the femoral head – 3 (10%), non–fusion of the osteotomy zone of the great trochanter - 1 (3,3%), heterotopic ossification of the abductor muscles – 1 (3,3%), persistent postoperative pain syndrome – 4 (13,3%).

Conclusion: performing an open surgical dislocation with FAI makes it possible to achieve complete correction of deformity. However, a significant number of complications indicates the need to consider minimally invasive techniques, such as arthroscopic correction and mini-open surgery.

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