In Search of the Spherical Femoroplasty: Cam Overresection Leads to Inferior Functional Scores Before and After Revision Hip Arthroscopic Surgery

Mansor, Yosif; Perets, Itay; Close, Mary R.; Mu, Brian; Domb, Benjamin G.

doi:10.1177/0363546518779064

Cited by 123 publications

(110 citation statements)

References 41 publications

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“…More commonly, excessive femoral resection has led to disruption of the native labral seal, adversely affecting hip joint biomechanics. 36 Mansor et al 11 reviewed a cohort of 120 patients (130 hips) and divided them into 3 groups (over-resected, under-resected, and neutral resected) who had a mean follow-up from index procedure of 39.6 months. The authors found that overresection greater than 5% of the femoral head diameter correlated with inferior clinical outcomes (modified Harris Hip Score) compared with the under-resected population.…”

Section: Discussionmentioning

confidence: 99%

“…documented to cause inferior clinical outcomes, 11 negatively affect hip joint biomechanics, 12 predispose to femoral neck fractures, [13][14][15] and produce a high conversion rate to total hip arthroplasty. 11 We present an arthroscopic surgical technique for achieving the perfectly spherical femoroplasty, meant to minimize complications using fluoroscopic guidance to confirm accuracy of resection, and ultimately improve postoperative patient outcomes. 11 Advantages, risks, and limitations for arthroscopic spherical femoroplasty are noted in Table 1.…”

mentioning

confidence: 99%

“…11 We present an arthroscopic surgical technique for achieving the perfectly spherical femoroplasty, meant to minimize complications using fluoroscopic guidance to confirm accuracy of resection, and ultimately improve postoperative patient outcomes. 11 Advantages, risks, and limitations for arthroscopic spherical femoroplasty are noted in Table 1. 11,16 This study was performed in accordance with the ethical standards in the 1964 Declaration of Helsinki.…”

mentioning

confidence: 99%

“…11 Advantages, risks, and limitations for arthroscopic spherical femoroplasty are noted in Table 1. 11,16 This study was performed in accordance with the ethical standards in the 1964 Declaration of Helsinki. This study was carried out in accordance with relevant regulations of the US Health Insurance Portability and Accountability Act.…”

mentioning

confidence: 99%

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

Lall

Annin

Chen

et al. 2020

Arthroscopy Techniques

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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.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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

Lall

Annin

Chen

et al. 2020

Arthroscopy Techniques

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“…An acetabuloplasty was performed to address pincer-type FAI and a femoroplasty was performed to address cam-type FAI. (16)(17)(18) Ligamentum teres (LT) tears were debrided; (19) full-thickness, chondral defects were addressed with microfracture; (20) and iliopsoas impingement lesions or painful internal snapping were treated with iliopsoas fractional lengthening. (21,22) Labral tears were treated with repair, debridement, resection, or reconstruction depending on the integrity of the labrum.…”

Section: Surgical Techniquementioning

confidence: 99%

Return to Play After Hip Arthroscopy Among Tennis Players: Outcomes with Minimum Five-Year Follow-up

Maldonado

Yelton

Rosinsky

et al. 2019

Preprint

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Background: Playing tennis is associated with various movements that can lead to labral injuries and may require arthroscopic surgery. While hip arthroscopies have demonstrated good outcomes in athletes, there is limited literature reporting Patient Reported Outcomes (PROs) and return to play in competitive or recreational tennis players after hip arthroscopic surgery. Therefore, the purpose of the present study was to (1) report minimum five-year PROs and return to sport in tennis players who underwent hip arthroscopic surgery and (2) compare outcomes between recreational and competitive tennis players. Methods: Data for patients who underwent hip arthroscopy surgery in the setting of femoroacetabular impingement (FAI) and labral tears between March 2009 and January 2014 and who played tennis at any level within one-year of surgery were retrospectively reviewed. Patients with preoperative and minimum five-year postoperative scores for the following PROs were included: modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Sport Specific Subscale (HOS-SSS), and visual analog scale (VAS) for pain. Patients with preoperative Tönnis osteoarthritis Grade >1, Workers’ Compensation claims, age > 60 years old, or previous ipsilateral hip surgeries or conditions were excluded. Patient Acceptable Symptomatic State (PASS) and Minimal Clinically Important Difference (MCID) for mHHS and HOS-SSS were calculated. Results: Of 28 patients, 31 hips met all inclusion and exclusion criteria of which 28 (90.3%) had minimum 5-year follow-up (mean: 72.8 ± 13.9 months). There were 3 professional, 3 collegiate, 2 high school, 2 organized amateur, and 18 recreational level tennis players. All PROs significantly improved at latest follow-up: mHHS from 67.0 to 86.7 (P < 0.001), NAHS from 65.9 to 87.2 (P < 0.001), HOS-SSS from 50.0 to 77.9 (P = 0.009), and VAS from 5.4 to 1.8 (P < 0.001). There was a 75.0% return to sport rate. Additionally, 66.7% of patients achieved MCID and 83.3% achieved PASS for mHHS, and 63.6% achieved MCID and 58.3% achieved PASS for HOS-SSS. Conclusion: Regardless of the level of participation, tennis players who underwent hip arthroscopic surgery reported statistically significant PRO improvements. A favorable rate of return to sport was also achieved.

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Surgical Technique: Arthroscopic Femoral Osteochondroplasty

Byrd¹

2022

Hip Arthroscopy and Hip Joint Preservation Surgery

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In Search of the Spherical Femoroplasty: Cam Overresection Leads to Inferior Functional Scores Before and After Revision Hip Arthroscopic Surgery

Cited by 123 publications

References 41 publications

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

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

Return to Play After Hip Arthroscopy Among Tennis Players: Outcomes with Minimum Five-Year Follow-up

Surgical Technique: Arthroscopic Femoral Osteochondroplasty

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