The April 1, 2015 JBJS features a level II prognostic study that analyzes registry data from 243 patients (mean age: 29) who underwent arthroscopic surgery to correct femoroacetabular impingement (FAI). Almost everyone experienced clinically important and statistically significant post-arthroscopy improvements in patient-reported outcomes. However, those with relative femoral retroversion (<5° anteversion) prior to surgery experienced smaller magnitudes of improvement than those with normal or increased femoral version.
Researchers found no association between the participants’ McKibbin index (calculated from both femoral and acetabular version) and patient-reported outcomes.
According to the authors and to commentator Keith Baumgarten, MD, these results indicate that surgeons should not consider femoral retroversion to be an absolute contraindication to arthroscopic correction of FAI. However, while the findings may help orthopaedists offer prognostic counseling to young and middle-aged adults who are considering arthroscopy for FAI, the authors say the findings “may not be externally valid in adolescents,” who represent a substantial percentage of patients diagnosed with this hip condition.
AAOS Now answers commonly asked coding questions for orthopaedic practices. This month’s column by Mary LeGrand, RN, senior consultant with KarenZupko & Associates, specifically addresses the following thorny coding issues in a Q&A format:
- Coflex interlaminar technology
- Modifier 51 or 59 in relation to intra-articular injections
- Open surgery for femoroacetabular impingement (FAI) syndrome
- Diskectomy and stenosis procedures
- ACL reconstruction