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Surgical Technique: Open Acetabular Rim Trimming, Labral Refixation, and Open Femoral Osteochondroplasty

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Hip Arthroscopy and Hip Joint Preservation Surgery

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Abstract

Femoroacetabular impingement (FAI) can be from a cam, a pincer, or a combined deformity. This deformity can lead to pathological contact between the femoral head and the acetabulum leading to limited range of motion, pain, labral tears, cartilage damage, and eventual osteoarthritis. Recent surgical advances in hip preservation surgery allow the orthopedic surgeon to address these deformities and potentially reverse the destructive changes of FAI. Understanding the underlying pathoanatomy is important in deciding which surgical approach to use. Although arthroscopy has become the main technique to address FAI, it has limitations in visualization, amount of resection possible, location of resection, or labral repair, and outcomes are influenced by surgeon experience. Open surgical dislocation provides excellent visualization of the proximal femur and of the acetabulum and offers excellent surgical access to the hip-preserving surgeon. The open approach allows the surgeon to address all pathologies associated with FAI: acetabular rim trimming, labral reattachment, and femoral osteochondroplasty. Multiple studies have shown this technique to be effective at alleviating symptoms and providing good, long-term patient-reported outcomes while preventing the need for arthroplasty.

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Author information

Authors and Affiliations

  1. Department of Surgery, University of Ottawa, Ottawa, ON, Canada

    Kevin Smit

  2. Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada

    Kevin Smit

  3. Orthopaedic Department, Division OT1, ASST G. Pini-CTO, Milan, Italy

    Luca Gala

  4. Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, ON, Canada

    Paul E. Beaulé

Authors
  1. Kevin Smit
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  2. Luca Gala
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  3. Paul E. Beaulé
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Corresponding author

Correspondence to Paul E. Beaulé .

Editor information

Editors and Affiliations

  1. Department of Orthopaedic Surgery, Division of Sports Medicine, Section of Young Adult Hip Surgery, Rush University Medical Center, Chicago, IL, USA

    Shane J. Nho

  2. Sports Medicine and Shoulder Service, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA

    Asheesh Bedi

  3. Department of Orthopaedic Surgery, Joint Preservation and Cartilage Restoration Center, University Hospitals Case Medical Center, Cleveland, OH, USA

    Michael J. Salata

  4. Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA

    Richard C. Mather III

  5. Department of Orthopaedic Surgery, Sports Medicine and Shoulder Service, Center for Hip Preservation Surgery Weill Medical College of Cornell University, Hospital for Special Surgery, New York, NY, USA

    Bryan T. Kelly

Section Editor information

  1. Hospital for Special Surgery, New York, United States

    Benedict U. Nwachukwu

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Smit, K., Gala, L., Beaulé, P.E. (2022). Surgical Technique: Open Acetabular Rim Trimming, Labral Refixation, and Open Femoral Osteochondroplasty. In: Nho, S.J., Bedi, A., Salata, M.J., Mather III, R.C., Kelly, B.T. (eds) Hip Arthroscopy and Hip Joint Preservation Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-43240-9_54

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  • DOI: https://doi.org/10.1007/978-3-030-43240-9_54

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