Arthroscopic Offset Restoration in Femoroacetabular Cam Impingement: Accuracy and Early Clinical Outcome

Stähelin, Lisca; Stähelin, Thomas; Jolles, Brigitte M.; Herzog, R.

doi:10.1016/j.arthro.2007.08.010

Cited by 115 publications

(107 citation statements)

References 24 publications

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“…However, our results are in accordance with those of Stähelin et al [34]. Our data suggest pain relief similar to that reported in two studies [21,34]. In our study, the average postoperative alpha angle, as measured on MRI, was 50.3°, which suggests good correction of the underlying disorder.…”

Section: Discussionsupporting

confidence: 82%

“…Data for postoperative ROM are sparse. However, our results are in accordance with those of Stähelin et al [34]. Our data suggest pain relief similar to that reported in two studies [21,34].…”

Section: Discussionsupporting

confidence: 80%

“…To avoid these problems associated with open surgery, arthroscopic offset correction is an up-and-coming procedure and usually can be performed on an outpatient basis. The accuracy and precision of this procedure have been confirmed [34,35]. One study reported on 19 patients with a substantial increase in WOMAC score after 2 years [17].…”

Section: Introductionmentioning

confidence: 88%

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Arthroscopic Treatment of Femoroacetabular Impingement of the Hip: A New Technique to Access the Joint

Horisberger

Brunner

Herzog

2010

Clinical Orthopaedics &Amp; Related Research

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127

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Femoroacetabular impingement has been established as an important cause of groin pain and limitation of range of motion in young, active patients and a possible cause for early osteoarthritis of the hip. Open surgery is a well-recognized approach for treatment and probably the standard for most surgeons, but recent reports regarding arthroscopic treatment procedures suggest comparable results. We present a technique that provides a way to securely penetrate the joint capsule and evaluate the clinical results of this technique in patients with femoroacetabular impingement. Between 2004 and 2007, we prospectively followed a cohort of 105 hips (88 patients; 60 males, 28 females) who underwent surgery for symptomatic cam or mixed femoroacetabular impingement. All patients were evaluated for the Nonarthritic Hip Score, clinical parameters, visual analog scale pain score, initial radiographic degenerative changes, and alpha angle. At a minimum followup of 1.3 years (average, 2.3 years; range, 1.3-4

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Section: Discussionsupporting

confidence: 82%

Section: Discussionsupporting

confidence: 80%

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Arthroscopic Treatment of Femoroacetabular Impingement of the Hip: A New Technique to Access the Joint

Horisberger

Brunner

Herzog

2010

Clinical Orthopaedics &Amp; Related Research

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127

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“…This disorder can result in labral-chondral injury and eventual osteoarthritic changes in the hip [2,7,10,25,29]. Numerous studies show the presence of OA negatively impacts improvements in pain and function after hip arthroscopy and nonarthroplasty open hip surgery [2,4,8,13,14,17,18,23,25,27,[29][30][31][32]35]. However, the majority of these studies predate resection of FAI impingement lesions [4,8,13,17,18,23,27,35], or are limited to small numbers [2,14,25,32].…”

Section: Introductionmentioning

confidence: 99%

Does Arthroscopic FAI Correction Improve Function with Radiographic Arthritis?

Larson

Giveans

Taylor

2011

Clinical Orthopaedics &Amp; Related Research

189

182

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Background Previous studies reporting the impact of osteoarthritis (OA) on pain and function after hip arthroscopy largely predate resection of femoroacetabular impingement (FAI). Questions/purposes We determined (1) functional improvement after resection of FAI impingement lesions in patients with preoperative radiographic joint space narrowing, and (2) identified preoperative predictors of pain, function, and failure rates in these patients.

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“…Studies have shown that neither the magnitude of correction of the alpha angle nor correction of the alpha angle to less than 50 is correlated with postoperative outcomes of pain, function, or increases in range of motion. 17,18 Although inadequate resection risks continued impingement, resection of greater than 30% of the femoral neck width risks fracture, 19 and overzealous proximal resection or poor contouring of the head-neck junction risks disruption of the labral seal. 16 Therefore the ideal amount of bony resection is a compromise and is dependent on surgeon judgment.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Femoral Neck Osteoplasty in the Treatment of Femoroacetabular Impingement

Chow

Kuzma

Krych

et al. 2014

Arthroscopy Techniques

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Femoral neck osteoplasty is an integral component for successful treatment of femoroacetabular impingement. Current techniques allow this to be performed arthroscopically, and results are equivalent to those of open procedures when typical anterior and anterosuperior lesions are considered. The arthroscopic procedure is dependent on obtaining adequate visualization through capsular management and proper leg positioning, and it requires fluoroscopy to guide and verify an adequate resection. We present our preferred technique for arthroscopic femoral neck osteoplasty.F emoroacetabular impingement (FAI) is a wellrecognized cause of hip pain in young adults and is associated with early-onset osteoarthritis.1 Two subtypes of impingement (pincer and cam) exist, and although they can occur independently, they most commonly coexist in an impinging hip.2 Cam impingement occurs as a result of an aspherical femoral head or a decreased femoral head-neck offset; this abnormal bony morphology is also sometimes referred to as a pistol-grip or tilt deformity. With hip motion, the abnormal bony prominence is repetitively forced into a generally spherical acetabulum, generating shear forces that can potentially result in tearing of the labrum and delamination of articular cartilage in the anterosuperior aspect of the acetabulum.Cam lesions are common. Recent studies in healthy volunteers have found that up to 35% of men and 10% of women have evidence of cam morphology on imaging studies (radiographs or magnetic resonance imaging).3,4 The prevalence is even higher among young, active male subjects, with studies of asymptomatic football and hockey players showing evidence of cam morphology in up to 75% of imaged hips. 5,6 Given the commonality of this lesion, the young population affected, and the potential for adverse longterm hip outcomes, the ability to effectively treat this lesion is paramount.The goal of treatment of symptomatic impinging cam lesions is to restore a spherical femoral head and a normal head-neck offset, thereby eliminating the impinging bone. Originally, this required an open approach as popularized by Ganz et al. 7 ; however, with recent technique advancements, this can now be performed arthroscopically. In the accompanying video presentation (Video 1), we demonstrate our technique for arthroscopic femoral neck osteoplasty for impinging cam lesions. Surgical TechniqueHip arthroscopy is performed in the usual fashion. It is our preference to perform this with the patient in the supine position using an anterolateral portal for viewing and a mid-anterior portal for working for the majority of the procedure. Additional working portals can be created as needed to facilitate cam resection in different locations on the femoral head and neck. Pathology in the central compartment is addressed first. This includes a pincer resection and/or labral repair, as appropriate. It also includes addressing areas of acetabular chondral delamination, which may require resection of unstable cartilage and possibly m...

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Arthroscopic Offset Restoration in Femoroacetabular Cam Impingement: Accuracy and Early Clinical Outcome

Cited by 115 publications

References 24 publications

Arthroscopic Treatment of Femoroacetabular Impingement of the Hip: A New Technique to Access the Joint

Arthroscopic Treatment of Femoroacetabular Impingement of the Hip: A New Technique to Access the Joint

Does Arthroscopic FAI Correction Improve Function with Radiographic Arthritis?

Arthroscopic Femoral Neck Osteoplasty in the Treatment of Femoroacetabular Impingement

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