Proposed Referential Index to Resect Femoroacetabular Cam-Type Impingement During Arthroscopy Using a Cadaveric Hip Model

Yamasaki, Shinya; Hashimoto, Yusuke; Terai, Shiro; Takigami, Junsei; Takahashi, Shinji; Nakamura, Hiroaki

doi:10.1016/j.arthro.2014.12.024

Cited by 8 publications

(4 citation statements)

References 36 publications

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“…Femoroacetabular impingement (FAI), a condition first described by Ganz et al 17 in 2003, is characterized by morphological abnormalities in the femoral head-neck junction and in the acetabulum. 42 It may be caused by a femoral cam lesion, acetabular overcoverage (pincer lesion), or most commonly a combination of the two. 40 A cam lesion is a relative increase in the diameter of the femoral neck compared with the femoral head at the head-neck junction 35 or, in simpler terms, a loss of sphericity of the femoral head.…”

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confidence: 99%

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

et al. 2018

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confidence: 99%

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

et al. 2018

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“…Three surgeons from the list of authors performed the surgeries in the supine position on a traction table under general anesthesia with a well-padded peroneal post. An anterolateral portal was established under fluoroscopy, then mid [ 7 , 8 ] or modified anterior [ 9 ] portals were established manually, and an inter-portal capsular cut was performed to improve their accessibility. Using a normal metallic probe, we confirmed the presence of a partial labral tear (i.e., imperfect detachment of acetabular rim from the bone) at the anterosuperior portion in all ten cases.…”

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confidence: 99%

Comparison of Labrum Resistance Force while Pull-Probing In Vivo and Cadaveric Hips

et al. 2021

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Cadaver tissue has been identified as the highest-fidelity anatomical representation in terms of the training for orthopedic surgery, including for arthroscopy of a damaged hip labrum. However, hip labrum stiffness in vivo and in cadavers has not been directly compared. The purpose of this study was to compare in vivo and cadaveric hip labrum stiffness during pull-probing with a force sensor. We measured the resistance force of the hip labrum in ten patients during hip arthroscopy (i.e., in vivo) and compared it with ten cadavers, both intact and detached from the acetabulum, using a surgical knife. We confirmed a partial labral tear (i.e., not detached fully from the rim) at an antero-superior potion in all of the patients. The mean highest resistance levels for the hip labrum in the patients (4.7 N) were significantly lower than the intact cadaveric labrum (8.3 N), and slightly higher than the detached labrum (4.2 N). In this study, the stiffness of the cadaveric labrum tissue was similar to that of the in-vivo hip labrum.

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“…Images of 3-dimensional computed tomography (3D-CT) are widely used for cam evaluation because they provide better evaluation of bony structures than magnetic resonance imaging (MRI). 16,28 Yet, it is still largely left to the surgeon’s experience to define the cam borders on 3D-CT. 31,32…”

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“…16 Images of 3-dimensional computed tomography (3D-CT) are widely used for cam evaluation because they provide better evaluation of bony structures than magnetic resonance imaging (MRI). 16,28 Yet, it is still largely left to the surgeon's experience to define the cam borders on 3D-CT. 31,32 The clinical imaging parameters for cam evaluation include the alpha angle, femoral head-neck offset ratio (hnoR), omega zone, and omega angle, among which the alpha angle is the most commonly used. 15,24 In the alpha angle measurement on 2-dimensional (2D) images, the superior border of the cam deformity is marked by the anterosuperior point where the distance from the bone to the center of the head first exceeds the radius of the femoral head.…”

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Evaluation of Cam Deformity on 3-Dimensional Computed Tomography With the Best-Fit Sphere Technique and the Alpha Angle Marking Method

et al. 2021

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Background: Three-dimensional computed tomography (3D-CT) is commonly used for the evaluation of cam deformity; however, it does not display the cam border directly. Purpose: To compare the efficacy of the best-fit sphere (BFS) method and the alpha angle marking (AAM) method in 3D-CT evaluation for the cam border. Study Design: Cohort study (Diagnosis); Level of evidence, 3. Methods: Twenty-six cases of cam deformity, confirmed during hip arthroscopy, were included in this study. All patients underwent a CT scan before surgery. Using multiplanar reconstruction, we obtained reformatted CT images of oblique axial, oblique coronal, and radial views. The alpha angle and femoral head-neck offset ratio (hnoR) were measured on the reformatted CT images. The cam area on 3D-CT was displayed in 4 different ways: by importing the markers from the reformatted CT images of the oblique axial view (cam-oa), the oblique coronal view (cam-oc), or the radial view (cam-r) using the AAM method, or by using the BFS method (cam-bfs). The sizes and locations of the displayed cams were compared. Results: All hips in this study had an alpha angle greater than 60° and an hnoR smaller than 0.17. The radial view measured a larger alpha angle and smaller hnoR than the oblique axial and coronal views ( P < .05). The areas of cam-oa, cam-oc, cam-r, and cam-bfs were 161.47 ± 27.96, 89.78 ± 19.23, 241.73 ± 34.55, and 329.75 ± 42.73 mm2, respectively, and their medial-to-lateral ranges along the acetabulum (clockface referents) were 12:30 to 03:00, 11:30 to 01:30, 11:30 to 03:00, and 11:00 to 03:30, respectively. Among the 4 displays, cam-bfs had the largest area and medial-to-lateral range ( P < .05), and cam-r had the second largest area and range ( P < .05). No significant difference in the mean distances from the acetabular rim to the superior border was detected among the 4 displays ( P > .05). Conclusion: The cam area displayed by the BFS method on 3D-CT was larger than those evaluated by the AAM method. In the reformatted CT, the sizes and locations of cam deformity differed among the oblique axial, oblique coronal, and radial views, with the radial view showing the greatest area.

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Proposed Referential Index to Resect Femoroacetabular Cam-Type Impingement During Arthroscopy Using a Cadaveric Hip Model

Cited by 8 publications

References 36 publications

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

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

Comparison of Labrum Resistance Force while Pull-Probing In Vivo and Cadaveric Hips

Evaluation of Cam Deformity on 3-Dimensional Computed Tomography With the Best-Fit Sphere Technique and the Alpha Angle Marking Method

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