PhD defence M.A. (Maarten) Röling

Dissertation in short:

Femoroacetabular impingement syndrome (FAI-syndrome) is a well-known cause of groin complaints and young and active patients. We describe how the FAI-syndrome can be recognized and what the incidence is in a general practitioner’s population. Every general practitioner could identify at least three patients in its practice every year.
It is essential to identify the impinging morphologies of the hip joint. For this aid, CT-scans were transformed into 3D dynamic models to recognize the impinging areas of the hip joint. We validated the use of these 3D dynamic models and analyzed the sensitivity and specificity compared to regular radiographs. Surgical resection of the impinging morphologies is done arthroscopically. We studied the traction force during arthroscopy to dislocate the hip joint to visualize the joint. These forces are high and lowers during the procedure. No specific correlation between the traction force and surgical complications were identified. Result of this treatment can be measured using specifically designed questionnaires; the PROM; patient reported outcome measures. We validated a Dutch translation of a widely used PROM, the Hip Outcome Score. We describe the functional outcomes results after surgery and concluded that patients treated by hip arthroscopy for an impinging hip improve significantly in pain and function, one-year after surgery. We developed a risk-factor prediction model to predict good recovery after surgery. In the final chapter we describe two different recovery patterns, “improvers” and “non-improvers” after surgery with two risk factors for “non-improvers” membership: high pre-operative pain-scores and arthrosis of the femoral head.