Introduction: Surgical treatment of femoroacetabular impingement (FAI) is becoming a worldwide current practice. We analyse if clinical and functional results are influenced by preoperative degenerative hip changes.

Materials and Methods: 107 FAI operated hips in 105 patients with a mean follow up of 3,1 years (range: 31 to 53 months) were evaluated and divided into 3 groups according to Tönnis Scala for preoperative radiological degenerative hip stages: group A 32 patients Tönnis 0, group B 61 Tönnis 1 and group C 24 Tönnis 2. Impingement test, Merle D’aubigné and WOMAC scores were assessed 6 weeks, 3 months, 6 months and every year after operation. SPSS 10.0 software used (SPSS INC, Chicago, Ill) was used for statistical analysis and comparisons were performed by means of chi-squared test; p< 0,05 was considered to be significant.

Results: After 3 months impingement test improved significantly in 30 cases Tönnis 0 (93,75%; p=0,012) and 58 cases Tönnis 1 (95,08%; p=0,008), whereas in Tönnis 2 it was observed only in 14 cases (58,3%; p=0,354). At this point no statistical difference was observed at the subsequent three years (p=0,273, p=0,377, p=0,334). Merle D’Aubigné and WOMAC scores improved significantly at the latest follow-up in groups A (91,3%, p=0,010) and B (93,4,%, p=0,024). However in group C only 45,8% of the cases improved significantly (p=0,383).

Conclusions: Surgical results of FAI differ in patients with Tönnis stage 0 and 1 when compared with Tönnis 2. Thus it seems to be reasonable to recommend symptomatic patients surgical treatment of FAI as early as it appears.

Introduction: today there is still no consense in reconstruction of severe acetabular defects in hip revision. Since 1988 we use size matched impacted acetabulum allografts. We evaluate how they behave in the mid–and longterm.

Materials and Methods: we present our first 44 transplants with a mean follow-up of 12,2 years (range 7 to 18). The mean age of the patients was 58,6 years (range 19 to 83). According to Gross Classification 26 cases presented an acetabular defect type III while 18 presented type IV. Evaluation included Merle D’Aubigne Score and radiological assessment of allograft and cup according to Engh Criteria (JBJS, 1994).

Results: homogenization of the radiological trabecular pattern was observed in 42 from 44 cases (95,4%). There were 3 infections and 7 cases of aseptic loosening (15,9%), that were revised with new cup implantation. Up to now none of these 7 cases have shown further signs of loosening. According to the Kaplan-Meier’s curves the overall predictive survival rate was 76.4% at 15 years. In cases of pelvic discontinuity (type IV) survivorship was significantly higher (85,7%, p=0,018). There was a highly marked improvement in Merle D’Aubigne Score in Gait (2,2 preoperative – 4,9 at follow-up, p=0,021) and Pain (2,5 preoperative – 5,4 at follow-up, p=0,032).

Conclusions: despite published reports with high incidence of failures in the midterm with structural allografts this serie shows clearly that a size matched impacted acetabulum allograft can be successfull in severe defficiencies if proper donor selection and excellent fixation technique is undertaken.