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Subspine Impingement and Surgical Technique

Hip Arthroscopy and Hip Joint Preservation Surgery

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Abstract

Femoroacetabular impingement is one of the causes of hip pain leading to acetabular labral tears and cartilage damage via mechanical overload that may lead to the development of early osteoarthritis. Recently, other causes of impingement have been described that may be associated with the painful nonarthritic hip. Anterior inferior iliac spine (AIIS)/subspine impingement is caused by abnormal contact between the AIIS and proximal femur with straight hip flexion. Recently, a classification system of the AIIS morphology has been proposed which may provide valuable information for the preoperative surgical plan. Radiographs, magnetic resonance imaging, ultrasound, or computed tomography may help to better elucidate the problem and differentiate between intra- and extra-articular pathology. The rationale of arthroscopic subspine decompression procedure has been supported recently demonstrating favorable results. Complex AIIS morphologies combined with significant intra-articular pathology can make the arthroscopic procedure challenging. Since long-term outcomes of arthroscopic subspine decompression are still forthcoming, safety should be the first priority. This can be accomplished by following specific principles such as detailed preoperative planning by utilizing advanced imaging modalities, avoidance of long traction times, and fluoroscopic imaging intraoperatively to assure adequate and accurate AIIS and cam resection.

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Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Center for Hip Pain and Preservation, Hospital for Special Surgery, 535 East 70th street, New York, NY, 10021, USA

    Lazaros A. Poultsides M.D. & Bryan T. Kelly M.D.

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  1. Lazaros A. Poultsides M.D.
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  2. Bryan T. Kelly M.D.
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Correspondence to Lazaros A. Poultsides M.D. .

Editor information

Editors and Affiliations

  1. Dept. of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA

    Shane Nho

  2. Dept. Orthopaedics, Hip Service, Schulthess Clinic, Zurich, Switzerland

    Michael Leunig

  3. Caspary Building, Ground Floor, Center for Hip Pain and Preservation, New York, New York, USA

    Bryan Kelly

  4. Department of Orthopaedics, University of Michigan Domino's Farms Lobby A, Ann Arbor, Michigan, USA

    Asheesh Bedi

  5. Twin Cities Orthopedics - Edina, Edina, Minnesota, USA

    Christopher Larson

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Poultsides, L.A., Kelly, B.T. (2014). Subspine Impingement and Surgical Technique. In: Nho, S., Leunig, M., Kelly, B., Bedi, A., Larson, C. (eds) Hip Arthroscopy and Hip Joint Preservation Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7321-3_68-1

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  • DOI: https://doi.org/10.1007/978-1-4614-7321-3_68-1

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  • Online ISBN: 978-1-4614-7321-3

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  1. Latest

    Subspine Impingement and Surgical Technique
    Published:
    08 April 2021

    DOI: https://doi.org/10.1007/978-1-4614-7321-3_68-2

  2. Original

    Subspine Impingement and Surgical Technique
    Published:
    16 April 2014

    DOI: https://doi.org/10.1007/978-1-4614-7321-3_68-1

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