Surgical Correction of “Cam-Type” Femoroacetabular Impingement: A Cadaveric Comparison of Open Versus Arthroscopic Debridement

Mardones, Rodrigo; Lara, Joaquín; Donndorff, Agustín; Barnes, Sunni A.; Stuart, Michael J.; Glick, James M.; Trousdale, Robert T.

doi:10.1016/j.arthro.2008.09.011

Cited by 72 publications

(33 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[8][9][10][11] When the treatment of typical anterior and anterosuperior cam lesions is specifically considered, the arthroscopic and open techniques are similar in that clinical studies have shown equivalent decreases in the extended-neck lateral alpha angle and improvement in the head-neck offset 12 ; cadaveric studies have shown FEMORAL NECK OSTEOPLASTY e23 equivalent bony resections in terms of volume, depth, width, and overall arc of resection. 13,14 However, Bedi et al 12 did find a significantly greater reduction in the anteroposterior alpha angle when an open approach was used in comparison to an arthroscopic approach. They suggested, therefore, that posterosuperior lesions might be more adequately addressed through an open approach with surgical dislocation.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Femoral Neck Osteoplasty in the Treatment of Femoroacetabular Impingement

Chow

Kuzma

Krych

et al. 2014

Arthroscopy Techniques

View full text Add to dashboard Cite

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...

show abstract

Section: Discussionmentioning

confidence: 99%

Arthroscopic Femoral Neck Osteoplasty in the Treatment of Femoroacetabular Impingement

Chow

Kuzma

Krych

et al. 2014

Arthroscopy Techniques

View full text Add to dashboard Cite

show abstract

“…Mardones et al 8 showed that the resection area tended to be positioned more posteriorly when using arthroscopic surgery versus an open surgery technique, thus introducing a potential risk of insufficient resection by arthroscopy. Our reference index is useful to confirm the preoperative planning during arthroscopic resection.…”

Section: Reference For Arthroscopic Cam Fai Resectionmentioning

confidence: 98%

“…However, the disadvantages of this technique include exposure of the articular cartilage to air, extensive soft-tissue dissection, trochanteric fixation failure, and heterotopic ossification. 8,9 Arthroscopic resection, conversely, is thought to be less invasive than open surgery in terms of softtissue dissection, low complication rates, and recovery period. 10,11 However, arthroscopic surgery requires technical skill to access and adequately visualize the hip joint.…”

mentioning

confidence: 97%

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

Yamasaki

Hashimoto

Terai

et al. 2015

Arthroscopy: The Journal of Arthroscopic & Related Surgery

View full text Add to dashboard Cite

“…Esto puede realizarse de forma artroscópica 13 o abierta a través de una luxación controlada de cadera 14,15 . En algunos casos de retroversión acetabular severa es necesario realizar una osteotomía periacetabular reversa 3,[14][15][16][17] .…”

Section: Tratamientounclassified

Pinzamiento femoroacetabular: Conceptos básicos en una nueva causa de dolor inguinal

R¹,

C²,

U³

et al. 2010

Rev. méd. Chile

View full text Add to dashboard Cite

Surgical Correction of “Cam-Type” Femoroacetabular Impingement: A Cadaveric Comparison of Open Versus Arthroscopic Debridement

Cited by 72 publications

References 21 publications

Arthroscopic Femoral Neck Osteoplasty in the Treatment of Femoroacetabular Impingement

Arthroscopic Femoral Neck Osteoplasty in the Treatment of Femoroacetabular Impingement

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

Pinzamiento femoroacetabular: Conceptos básicos en una nueva causa de dolor inguinal

Contact Info

Product

Resources

About