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Arthroscopy and open surgery are equally efficacious in treating common hip problem in most patients
Date:7/8/2011

der 40 years of age who had symptomatic FAI. Thirty consecutive patients were treated with open surgery and 30 consecutive patients were treated with arthroscopy. X-rays were taken both before and after surgery. The researchers analyzed angles in the X-rays that determine the roundness of the femoral head, the ball of the thigh bone, and found that for the most part, both surgeries repaired sphericity similarly. They found that the two surgeries also similarly repaired the degree of separation between the sphere of the femoral head and the edge of the socket.

"The short term goal of treating FAI is symptom improvement and return to a higher level of function, but the long-term goal is to improve mechanics across the joint so that the cartilage wears at a slower rate and the health of the joint is preserved longer," said Dr. Kelly. "The ability of the procedure to do that is really based upon precise structural correction. This is the first study in patients to show that we can achieve similar mechanical correction arthroscopically." He noted that they had previously demonstrated this in a study involving cadavers.

In the current study, the researchers did find that one particular angle, called the anteroposterior (AP) alpha angle, was better repaired with open surgery. The AP alpha angle was reduced by 25.7% in the open surgery group and 16.8% in the arthroscopic procedure. This angle also involves the sphericity of the femoral head.

Dr. Kelly said that if doctors determine a patient has a large AP alpha angle, that patient might be better suited for open surgery. "People who have large alpha angles on their AP on the front view X-ray are ones that you might consider alternative surgical techniques to arthroscopy," said Dr. Kelly. "That is one particular location that is hard to get to."

Not all patients with FAI need to undergo surgery. Treatment usually begins with rest, activity modifications, careful use of anti-inflammator
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Contact: Phyllis Fisher
phyllis.fisher@gmail.com
212-606-1724
Hospital for Special Surgery
Source:Eurekalert

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