Does the Femoral Cam Lesion Regrow after Arthroscopic Femoroplasty in the Skeletally Immature Patient with an Open Femoral Head Physis? Radiographic and Clinical Follow-Up ≥2-Years

Purpose: To determine if there is bony regrowth in skeletally immature patients with open femoral head physes undergoing femoral osteoplasty during hip arthroscopy for the treatment of FAI and labral pathology.

Methods: Eleven hips (10 patients) with open femoral head physes underwent femoroplasty between October 2008 and November 2013. Inclusion criteria were minimum two-year follow-up with patient-reported outcomes (PRO) and x-rays preoperatively, two-weeks, and at a minimum of two-years postoperatively. Exclusion criteria were preoperative Tönnis grade > 1 and previous hip conditions. Alpha angles were measured preoperatively, two weeks, and at a minimum of two years postoperatively. PROs, including the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score – Sports Specific Subscale (HOS-SSS), Visual Analog Scale (VAS), were measured preoperatively and at latest follow-up.

Results: Mean age at surgery was 14.7 years. Mean follow-up was 35.7 months. All hips tested positive for anterior impingement preoperatively. The mean preoperative alpha angle was 61.8°, which decreased to 41.5° postoperatively (p < 0.0001) and was 40.7° at a minimum of two years postoperatively. No bony regrowth was documented at latest follow-up. Mean improvements in scores were as follows: mHHS (58.5 to 79.8; p < 0.0001), NAHS (56.8 to 87.1; p = 0.008), HOS-SSS (34.3 to 78.3; p = 0.004), and VAS (7.5 to 1.3; p < 0.0001). Mean patient satisfaction was 8.7 ± 1.7. Two hips (18.2%) required revision arthroscopy at a mean of 24.8 months. No postoperative complications were reported.

Conclusions: Bony regrowth of the femoral head-neck region is unlikely to occur in skeletally immature females who underwent arthroscopic femoroplasty. In this group of patients, hip arthroscopic treatment of FAI and labral tears is a safe and favorable intervention due to its high patient satisfaction and outcome scores and absence of postoperative complications.