Arthroscopic Treatment and Injection of Plasma Rich in Growth Factors in the Treatment Femoroacetabular Impingement of the Hip: Results with Two Years of Follow-up

Abstract

Femoroacetabular impingement has been described as a cause of injury to the acetabular labrum and degeneration of the hip joint. Surgical treatment is based in correction of the femoral neck deformity as well as the prominence of the anterior acetabular rim by open and arthroscopic techniques. A prospective study performed between April 2011 and April 2012 with 44 consecutive patients with osteoarthritic changes of the hip (Tönnis grade 1 and 2) and symptomatic femoroacetabular impingement underwent arthroscopic debridement of the acetabular rims and femoral neck. During the same period of time, 28 patients consecutively underwent hip arthroscopy without degenerative changes. All patients had injection of plasma rich in growth factors into the affected hip joint. We evaluated the results at two years after surgery using general and specific validated instruments. Eight patients (7 Tennis 2 and 1 Tennis 1) underwent a second surgery for total hip replacement within the 2-year minimum follow-up. 36 (81.8%) of the 44 patients showed statistically significant improvement in pain, stiffness and functional capacity in evaluation by HOS, WOMAC, mHHS and VAS. This study showed good results in patients after arthroscopic debridement of the acetabular rim and femoral neck for femoroacetabular impingement and injection of plasma rich in osteoarthritic hips. This surgery in properly selected patients can improve patients’ pain, stiffness and functional capacity for at least two years after surgery. It is unclear whether the surgery alone or the addition of plasma rich in growth factors was responsible for the results. Level of evidence. Level IV of evidence, therapeutic case series.