Midterm Results of Surgical Hip Dislocation for the Treatment of Femoroacetabular Impingement
Bibliographic record
Abstract
BACKGROUND: Surgical treatment of femoroacetabular impingement (FAI) includes both open and arthroscopic procedures. Encouraging results have been reported for the majority of patients after surgical hip dislocation; however, most of these reports were short term and included only small cohorts. PURPOSE: To determine the results of surgical hip dislocation in a large cohort of FAI patients at a midterm follow-up. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: A retrospective study including 185 consecutive patients (mean age, 30 years; 40% female) with 233 hips treated was conducted. We determined clinical outcomes in terms of range of motion and analyzed radiographs for several criteria including the alpha angle preoperatively and at 1 year postoperatively. At latest follow-up, on average 61 months postoperatively, patient satisfaction, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Hip Outcome Score, SF-12, and University of California, Los Angeles (UCLA) activity scale scores were determined. All revisions and conversions to total hip arthroplasty (THA) were recorded. RESULTS: Both hip flexion and internal rotation improved from preoperatively to postoperatively. Alpha angles decreased from 65.1° ± 14.2° to 42.4° ± 4.9°. At 5 years, 82% of the patients were satisfied or very satisfied with the results of surgery, and 81% would undergo the same surgery again. There were 83% who rated their overall hip function as normal or nearly normal. Mean scores for the WOMAC pain, stiffness, and function subscales were 10.3 ± 15.8, 15.9 ± 17.4, and 9.6 ± 13.0 points; for Hip Outcome Score activities of daily living and sport subscales were 89.0 ± 13.1 and 75.6 ± 23.0 points; and for the SF-12 Physical Component Scale and Mental Component Scale were 47.4 ± 6.3 and 52.3 ± 7.4 points, respectively. The mean UCLA activity level was 7.7 ± 1.9. Conversion to THA was performed in 7 hips (3%). Seven hips (3%) underwent other major revisions, and 11 (4.7%) underwent minor revisions. Female patients had a significantly increased risk for conversion to THA (odds ratio, 13.3; 95% confidence interval [CI], 1.3-92.6) and major revision (odds ratio, 19.2; 95% CI, 2.4-152.9). The mean body mass index was significantly lower in those patients who underwent conversion to THA. The need for microfracture because of residual full-thickness cartilage defects after rim trimming was a significant (P = .04) predictor of subjective dissatisfaction. CONCLUSION: This study demonstrates that surgical hip dislocation is a successful procedure for the treatment of FAI. A majority of patients were satisfied with the results of surgery at a midterm follow-up. Older and slim female patients were at an increased risk for a less successful outcome in terms of conversion to THA and revision surgery.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".