Document Detail


Evaluation of a computed tomography-based navigation system prototype for hip arthroscopy in the treatment of femoroacetabular cam impingement.
MedLine Citation:
PMID:  19341925     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The purpose of this study was to investigate the impact of a new computed tomography-based computer navigation system on the accuracy of arthroscopic offset correction in patients with cam type femoroacetabular impingement (FAI), and to evaluate if the accuracy of offset restoration compromises the early clinical outcome. METHODS: We prospectively treated 50 patients (25 navigated and 25 non-navigated) by hip arthroscopy and arthroscopic offset restoration for cam FAI. The patients were a mean age 42.9 years, and the average follow-up was 26.7 months, with no patients lost to follow-up. Magnetic resonance imaging scans were performed preoperatively and 6 weeks postoperatively. A postoperative alpha angle of less than 50 degrees or a reduction of the alpha angle of more than 20 degrees was considered to be successful offset restoration. Outcomes were measured with a visual analogue scale for pain, range of motion, and the nonarthritic hip score. RESULTS: The mean alpha angle improved from 76.5 degrees (range, 57 degrees to 110 degrees) to 54.2 degrees (range, 40 degrees to 84 degrees). In both the navigated and the non-navigated groups, 6 patients (24%) showed insufficient offset correction. Range of motion, visual analogue scale for pain scores, and nonarthritic hip scores significantly improved in all subgroups. Statistical analysis showed no significant difference regarding the clinical outcome between patients with sufficient and insufficient correction of the alpha angle. CONCLUSIONS: In this series, a significant percentage of patients (24%) showed an insufficient correction of the alpha angle after hip arthroscopy for cam FAI. This study shows that the presented navigation system could not improve this rate and that the insufficient accuracy of reduction of the alpha angle does not appear to compromise the early clinical outcome. LEVEL OF EVIDENCE: Level II, prospective comparative study.
Authors:
Alexander Brunner; Monika Horisberger; Richard F Herzog
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article     Date:  2009-02-11
Journal Detail:
Title:  Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association     Volume:  25     ISSN:  1526-3231     ISO Abbreviation:  Arthroscopy     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-04-03     Completed Date:  2009-06-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8506498     Medline TA:  Arthroscopy     Country:  United States    
Other Details:
Languages:  eng     Pagination:  382-91     Citation Subset:  IM    
Affiliation:
Department of Orthopedic Surgery, Cantonal Hospitals Lucerne, Wolhusen, Switzerland. a-r.brunner@web.de
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MeSH Terms
Descriptor/Qualifier:
Acetabulum / radiography*,  surgery*
Adolescent
Adult
Aged
Arthroscopy / methods*
Female
Follow-Up Studies
Hip Joint / physiopathology,  radiography*,  surgery*
Humans
Joint Diseases / radiography*,  surgery*
Magnetic Resonance Imaging
Male
Middle Aged
Nerve Compression Syndromes / radiography,  surgery
Preoperative Care
Prospective Studies
Range of Motion, Articular
Tomography, X-Ray Computed / methods
Treatment Outcome
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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