Arthroscopic Treatment of Bilateral Femoroacetabular Friction Syndrome of the Hip. Comparative Study Between One and Two Stages
DOI:
https://doi.org/10.63403/re.v32i1.383Keywords:
Hip Arthroscopy, Simultaneous, Stage Arthroscopy, Clinical, Functional, ComplicationsAbstract
Introduction: the success of hip arthroscopy for the treatment of femoroacetabular friction syndrome (FAFS) has been reported by multiple authors. In case both hips are affected, there is controversy about performing simultaneous or delayed bilateral arthroscopy.
Purpose: the purpose of this study was to compare the clinical and functional outcomes and complication rate of patients diagnosed with bilateral FAPS treated by bilateral one-stage and two-stage arthroscopy.
Materials and methods: adult patients with a diagnosis of bilateral femoroacetabular friction syndrome were retrospectively analyzed and outcomes were compared between those treated by simultaneous bilateral arthroscopy and those treated by delayed bilateral arthroscopy. Clinical evaluation was performed using the Hip Scale (HOS) and Visual Analog Pain Scale (VAS). In addition, complication and failure rates were recorded.
Results: the series consisted of 64 patients, 41 (64.1%) treated simultaneously with a mean follow-up of 40 months. A statistically significant difference was observed with respect to HOS scale values in favor of patients treated in one stage. There were no significant differences with respect to VAS scale, complications or failures.
Conclusion: arthroscopic treatment of FFS of both hips treated in one or two stages is a safe procedure with good clinical and functional results and low complication and revision rates after 40 months of follow-up.
References
Ramamurti P, Kamalapathy P, Werner BC, Gwathmey FW. Staging bilateral hip arthroscopies less than 1 year apart may reduce the risk of revision surgery. Arthroscopy. 2023 Mar;39(3):730-737.e3. doi: https://doi.org/10.1016/j.arthro.2022.09.011.
Ayeni OR, Karlsson J, Philippon MJ, Safran MR. Diagnosis and management of femoroacetabular impingement: an evidence-based approach. London: Springer Cham; c2017. 279 p. doi: https://doi.org/10.1007/978-3-319-32000-7.
Allen D, Beaulé PE, Ramadan O, Doucette S. Prevalence of associated deformities and hip pain in patients with cam-type femoroacetabular impingement. J Bone Joint Surg Br. 2009 May;91(5):589–594.doi: https://doi.org/10.1302/0301-620X.91B5.22028.
Kohno Y. Letter to the editor: bilateral femoroacetabular impingement: what is the fate of the asymptomatic hip? Clin Orthop Relat Res. 2019 Nov;477(11):2607–2608. doi: https://doi.org/10.1097/CORR.0000000000000974.
Degen RM, Nawabi DH, Fields KG, Wentzel CS, Kelly BT, Coleman SH. Simultaneous versus staged bilateral hip arthroscopy in the treatment of femoroacetabular impingement. Arthroscopy. 2016 Jul;32(7):1300–1307. doi: https://doi.org/10.1016/j.arthro.2016.01.047.
Griffin DR, Dickenson EJ, O'Donnell J, Agricola R, Awan T, Beck M, et al. The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement. Br J Sports Med. 2016 Oct;50(19):1169-1176. doi: https://doi.org/10.1136/bjsports-2016-096743.
Vilaseca T; Chahla J. Artroscopía de cadera: indicaciones, resultados y complicaciones. Revisión bibliográfica y experiencia personal. Artroscopía. 2015;22(3):107–113. Disponible en: https://revistarelart.com/ediciones-anteriores/images/artroscopia/volumen-22-nro-3/PDF/22_03_09_Vilaseca.pdf.
Pérez Alamino L, Catan A, Veloz Serrano D, Chahla JA, Vilaseca TR. Síndrome de fricción femoroacetabular: tratamiento artroscópico. Resultados a mediano plazo, complicaciones y fallas. Artroscopía. 2020;27(4):172–177. Disponible en: https://revistarelart.com/index.php/revista/article/view/92/92.
Byrd JW. Hip arthroscopy utilizing the supine position. Arthroscopy. 1994 Jun;10(3):275-80. doi: https://doi.org/10.1016/s0749-8063(05)80111-2.
Locks R, Chahla J, Mitchell JJ, Soares E, Philippon MJ. Dynamic hip examination for assessment of impingement during hip arthroscopy. Arthrosc Tech. 2016 Nov 28;5(6):e1367-e1372. doi: https://doi.org/10.1016/j.eats.2016.08.011.
Outerbridge RE. The etiology of chondromalacia patellae. J Bone Joint Surg Br. 1961 Nov;43-B:752–757. doi: https://doi.org/10.1302/0301-620X.43B4.752.
Lerch TD, Meier MK, Boschung A, Steppacher SD, Siebenrock KA, Tannast M, et al. Diagnosis of acetabular retroversion: three signs positive and increased retroversion index have higher specificity and higher diagnostic accuracy compared to isolated positive cross over sign. Eur J Radiol Open. 2022 Feb 25;9:100407. doi: https://doi.org/10.1016/j.ejro.2022.100407.
Martin RL, Kelly BT, Philippon MJ. Evidence of validity for the hip outcome score. Arthroscopy. 2006 Dec;22(12):1304-1311. doi: https://doi.org/10.1016/j.arthro.2006.07.027.
Collins SL, Moore RA, McQuay HJ. The visual analogue pain intensity scale: what is moderate pain in millimetres? Pain. 1997 Aug;72(1-2):95-97. doi: https://doi.org/10.1016/s0304-3959(97)00005-5.
Essilfie AA, Bloom DA, Zusmanovich M, Kester B, Wolfson T, Youm T. Staged bilateral hip arthroscopy compared with a matched unilateral hip arthroscopy group: minimum 2-year follow-up. Arthroscopy. 2020 Jul;36(7):1856–1861. doi: https://doi.org/10.1016/j.arthro.2020.02.025.
Fernandez CE, Morgan AM, Sheth U, Tjong VK, Terry MA. Bilateral versus unilateral hip arthroscopy for femoroacetabular impingement: a systematic review. J Hip Preserv Surg. 2020 Mar 28;7(2):225-232. doi: https://doi.org/10.1093/jhps/hnaa013.
Jack RA 2nd, Sochacki KR, Hirase T, Vickery JW, Harris JD. Performance and return to sport after hip arthroscopy for femoroacetabular impingement in professional athletes differs between sports. Arthroscopy. 2019 May;35(5):1422-1428. doi: https://doi.org/10.1016/j.arthro.2018.10.153.
Malviya A, Stafford GH, Villar RN. Impact of arthroscopy of the hip for femoroacetabular impingement on quality of life at a mean follow-up of 3.2 years. J Bone Joint Surg Br. 2012 Apr;94(4):466–470. doi: https://doi.org/10.1302/0301-620X.94B4.28023.
McConkey MO, Chadayammuri V, Garabekyan T, Mayer SW, Kraeutler MJ, Mei-Dan O. Simultaneous bilateral hip arthroscopy in adolescent athletes with symptomatic femoroacetabular impingement. J Pediatr Orthop. 2019 Apr;39(4):193–197. doi: https://doi.org/10.1097/BPO.0000000000000987.
Marty E, Keeter C, Henry K, Kraeutler MJ, Lee JH, Mei-Dan O. Midterm outcomes after simultaneous hip arthroscopic surgery for bilateral femoroacetabular impingement. Am J Sports Med. 2024;52(10):2596-2602. doi: https://doi.org/10.1177/03635465241263597.
Matsuda DK, Ching K, Matsuda NA. Simultaneous bilateral hip arthroscopy. Arthrosc Tech. 2017 Jul 3;6(4):e913-e919. doi: https://doi.org/10.1016/j.eats.2017.03.002.
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Copyright (c) 2025 Leonel Pérez Alamino, María A. Olarán, Genaro Cucalón, Daniel Veloz Serrano, Gonzalo Quiroga, Tomás R. Villaseca
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