Midterm outcomes in patients with cam femoroacetabular impingement treated arthroscopically

Arthroscopy. 2012 Nov;28(11):1671-81. doi: 10.1016/j.arthro.2012.04.154. Epub 2012 Sep 6.


Purpose: The purpose of this study was to evaluate the midterm outcomes of patients with cam-type femoroacetabular impingement treated arthroscopically.

Methods: Outcomes were measured with the Nonarthritic Hip Score (NAHS), visual analog scale pain scores, and satisfaction levels preoperatively; at 6 weeks and 3, 6, 12, and 24 months postoperatively; and at final follow-up. Two hundred one procedures were available for final assessment with a minimum follow-up of 36 months (mean, 46 months). Ninety-nine percent of hips had a preoperative Tönnis grade of 1 or less.

Results: The NAHS significantly improved from a mean of 56.1 to 78.2 (P < .001). Visual analog scale pain scores improved from a mean of 6.8 to 2.7 (P < .001). Preoperative to postoperative satisfaction levels improved from 0.5% to 75% of procedures. Twelve patients required hip arthroplasty during the follow-up period and had a higher incidence of grade 4 acetabular chondral defects versus those without arthroplasty (P < .03). Patients with pincer resections had significantly poorer results versus the remainder of the cohort (P < .01).

Conclusions: We have shown satisfactory results using a validated hip scoring system, showing improvement in NAHS, pain scores, and satisfaction levels in a large cohort of patients with cam-type femoroacetabular impingement followed up for a mean of 46 months. The results have shown improvement and stability throughout a range of 36 to 70 months' follow-up. There was no difference in preoperative to postoperative NAHS between age groups. There was a larger percentage of grade 4 acetabular chondral defects in those patients who needed conversion to hip arthroplasty. Patients with associated pincer pathology had poorer results after acetabular rim resection.

Level of evidence: Level IV, therapeutic case series.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Arthroscopy / methods*
  • Female
  • Femoracetabular Impingement / diagnosis
  • Femoracetabular Impingement / physiopathology
  • Femoracetabular Impingement / surgery*
  • Follow-Up Studies
  • Hip Joint / physiopathology
  • Humans
  • Male
  • Middle Aged
  • Pain Measurement
  • Patient Satisfaction / statistics & numerical data*
  • Range of Motion, Articular
  • Sex Distribution
  • Treatment Outcome
  • Young Adult