Arthroscopic Technique for Treatment of Femoroacetabular Impingement

Arthroscopic osteochondroplasty has become the most common treatment for cam-type femoroacetabular impingement. However, gauging the appropriate depth and location of the femoral osteochondroplasty remains challenging, given the parallax observed from using a 70 arthroscope across multiple viewing perspectives. Consequently, reliable techniques must use a combination of arthroscopic and fluoroscopic checks and balances to assess the femoral head-neck junction to help guide bony resection. We have developed a technique for osteochondroplasty that has made the process more efficient and reliable in our hands. It involves creating a trough at the apex of the osteochondroplasty and then contouring the proximal and distal regions to re-create normal proximal femoral geometry. This article details our technique for femoral osteochondroplasty, which can be performed alone for isolated cam impingement or in concert with other intra-and extra-articular procedures to address associated hip pathology.

“…Advantages and risks or limitations of our technique are detailed in Table 2. This is contrary to the osteoplasty technique described by Jackson et al 10 that…”

Section: Discussioncontrasting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

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Arthroscopic Femoral Osteochondroplasty for Cam-Type Femoroacetabular Impingement: The Trough Technique

Aoki

Beckmann

Wylie

2016

“…Although beyond the scope of this article, the presence of other abnormalities commonly seen with FAI should be systematically identified, classified, and treated with grading schemes and treatment algorithms previously described. 21,22 Other abnormalities you may encounter and address include ligamentum teres and labral tears, loose bodies, acetabular cartilage damage, and uncommon extra-articular lesions.…”

Section: Part C Diagnostic Arthroscopy Central Compartment Managementmentioning

confidence: 99%

Achieving a Perfectly Spherical Femoroplasty: Pearls, Pitfalls, and Optimal Surgical Technique

Lall

Annin

Chen

et al. 2020

Self Cite

Femoroacetabular impingement describes a pathologic interaction between the bony femoral head/neck junction and acetabulum. Cam-type femoroacetabular impingement results from an aspherical femoral head architecture, which increases early contact along the acetabular surface during hip range of motion. Errant arthroscopic femoroplasty recently has been discussed within the literature to describe a preventable etiology of failed hip arthroscopy, most notably cam over-and under-resection. We present an arthroscopic surgical technique for achieving the perfectly spherical femoroplasty, meant to minimize complications and improve postoperative outcomes.

“…Mini-open and arthroscopic procedures have shown similar results at midterm follow-up. [6][7][8] An arthroscopic technique to perform cam osteoplasty, pincer osteoplasty, labral repair, and capsular repair/plication is discussed (Table 1).…”

mentioning

confidence: 99%

Arthroscopic Technique for Treatment of Combined Pathology Associated With Femoroacetabular Impingement Syndrome Using Traction Sutures and a Minimal Capsulotomy

Thakral

Ochiai

2014

The use of hip arthroscopy is gaining popularity for diagnostic and therapeutic purposes. With our increasing understanding of hip biomechanics and pathophysiology, our techniques for treatment are evolving as well. The main aim is to preserve the joint and prolong the degenerative process associated with femoroacetabular impingement (FAI). In general, combined pathology is encountered when a diagnosis of FAI is established. In our experience, we have seen large number of patients with a combination of cam and pincer lesions with or without associated labral tears. It is optimal to address all symptomatic pathology with one surgical intervention. The described technique shows the feasibility of dealing with the hip FAI pathology by using traction sutures on the capsule through a 2-portal technique.