Abstract
Ganz termed cam impingement “the silent killer of the hip” because advanced damage occurs to the aneural acetabular articular surface before the densely innervated labrum starts to fail, creating symptoms. There is a high predilection for active young adult males where breakdown occurs as the joint exceeds its diminished physiologic limits imposed by the altered morphology. The clinical assessment and imaging are detailed in this chapter. The arthroscope is an important part of the surgical treatment algorithm, identifying the secondary damage that indicates pathological impingement and the need for correction of the underlying cam bump. Most can be corrected arthroscopically and the technique is detailed. With proper patient selection, the results are quite favorable with few complications.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Byrd JWT, Jones KS. Arthroscopic “femoroplasty” in the management of cam-type femoroacetabular impingement. Clin Orthop Relat Res. 2009;467:739–46.
Siebenrock KA, Wahab KHA, Werlen S, Kalhor M, Leunig M, Ganz R. Abnormal extension of the femoral head epiphysis as a cause of cam impingement. Clin Orthop Rel Res. 2004;418:54–60.
Byrd JWT. Physical examination. In: Byrd JWT, editor. Operative hip arthroscopy. 2nd ed. New York: Springer; 2005. p. 36–50.
Meyers WC, Foley DP, Garrett WE, Lohnes JH, Mandlebaum BR. Management of severe lower abdominal or inguinal pain in high-performance athletes. PAIN (Performing athletes with abdominal or inguinal neuromuscular pain study group). Am J Sports Med. 2000;28(1):2–8.
Ganz R, Parvizi J, Beck M, Leunig M, Notzli H, Siebenrock KA. Femoroacetabular impingement: a cause for osteoarthritis in the hip. Clin Orthop. 2003;417:112–20.
Parvizi J, Leunig M, Ganz R. Femoroacetabular impingement. J Am Acad Ortho Surg. 2007;15(9):561–70.
Meyer DC, Beck M, Ellis T, Ganz R, Leunig M. Comparison of six radiographic projections to assess femoral head/neck asphericity. Clin Orthop. 2006;445:181–5.
Notzli H, Wyss TF, Stoecklin CH, Schmid MR, Treiber K, Hodler J. The contour of the femoral head/neck junction as a predictor for the risk of anterior impingement. J Bone Joint Surg Br. 2002;84(4):556–60.
Byrd JWT, Jones KS. Diagnostic accuracy of clinical assessment, MRI, gadolinium MRI, and intraarticular injection in hip arthroscopy patients. Am J Sports Med. 2004;32(7):1668–74.
Su AW, Hillen TJ, Eutsler EP, et al. Low-dose computed tomography reduces radiation exposure by 90% compared with traditional computed tomography among patients undergoing hip-preservation surgery. Arthroscopy. 2019;35(5):1385–92.
Philippon MJ, Schenker ML. Arthroscopy for the treatment of femoroacetabular impingement in the athlete. Clin Sports Med. 2006;25(2):299–308.
Anderson LA, Anderson MB, Kapron A, et al. The 2015 Frank Stinchfield Award: radiographic abnormalities common in senior athletes with well-functioning hips but not associated with osteoarthritis. Clin Orthop Relat Res. 2016;474(2):342–52.
Frank JM, Harris JD, Erickson BJ, et al. Prevalence of femoroacetabular impingement imaging findings in asymptomatic volunteers: a systematic review. Arthroscopy. 2015;31(6):1199–204.
Louer CR, Pashos G, Clohisy JC, et al. A prospective analysis of the contralateral hip among patients with femoroacetabular impingement: what are the risk factors for disease progression? Am J Sports Med. 2018;46(10):2486–91.
Tönnis D, Heinecke A. Acetabular and femoral anteversion: relationship with osteoarthritis of the hip. J Bone Joint Surg Am. 1999;81:1747–70.
Philippon MJ, Briggs KK, Yen YM, et al. Outcomes following hip arthroscopy for femoroacetabular impingement with associated chondrolabral dysfunction: minimum two-year follow-up. J Bone Joint Surg Br. 2009;91:16–23.
Larson CM, Giveans MR, Taylor M. Does arthroscopic correction. improve function with radiographic arthritis? Clin Orthop Relat Res. 2010;468:555–64.
Byrd JWT, Bardowski EA, Jones KS. Influence of Tönnis grade on outcomes of arthroscopic management of symptomatic femoroacetabular impingement. Arthroscopy. 2018;34(8):2353–6.
Byrd JWT, Jones KS, Bardowski EA. Influence of Tönnis grade on outcomes of arthroscopy for FAI in athletes: a comparative analysis. J Hip Preserv Surg. 2018;5(2):162–5.
Byrd JWT. Hip arthroscopy utilizing the supine position. Arthroscopy. 1994;10(3):275–80.
Byrd JWT. Routine arthroscopy and access: central and peripheral compartments, iliopsoas bursa, peritrochanteric, and subgluteal spaces. In: Byrd JWT, editor. Operative hip arthroscopy. 3rd ed. New York: Springer; 2012. p. 131–60.
Byrd JWT (2012) Hip access: fundamental principles. Sports Medicine & Arthroscopy Multimedia Education Center, American Academy of Orthopaedic Surgeons 2012 Annual meeting, San Francisco, California, February 7–11, 2012.
O’Connor M, Minkara AA, Westermann RW, et al. Outcomes of joint preservation procedures for cartilage injuries in the hip: a systematic review and meta-analysis. Orthop J Sports Med. 2018;6(6):2325967118776944.
Byrd JWT, Jones KS. Arthroscopic Management of Femoroacetabular Impingement (FAI) in athletes. Am J Sports Med. 2011;39:7S–13S.
Ilizaliturri VM, Orozco-Rodriguez L, Acosta-Rodriguez E, Camacho-Galindo J. Arthroscopic treatment of cam-type femoroacetabular impingement. J Arthroplast. 2008;23(3):226–34.
Bardakos NV, Vasconcelos JC, Villar RN. Early outcome of hip arthroscopy for femoroacetabular impingement: the role of femoral osteoplasty in symptomatic improvement. J Bone Joint Surg Br. 2008;90:1570–5.
Brunner A, Horisberger M, Herzog RF. Sports and recreation activity of patients with femoroacetabular impingement before and after arthroscopic osteoplasty. Am J Sports Med. 2009;37:917–22.
Larson CM, Sikka RS, Sardelli MC, Byrd JWT, Kelly BT, Jain RK, Giveans MR. Increasing alpha angle is predictive of athletic-related “hip” and “groin” pain in collegiate National Football League Prospects. Arthroscopy. 2013;29(3):405–10.
Domb BG, Annin S, Chen JW, et al. Optimal treatment of cam morphology may change the natural history of femoroacetabular impingement. Am J Sports Med. 2020;48(12):2887–96.
Philippon MJ, Wolff AB, Briggs KK, Zehms CT, Kuppersmith DA. Acetabular rim reduction for the treatment of femoroacetabular impingement correlates with preoperative and postoperative center-edge angle. Arthroscopy. 2010;26(6):757–61.
Briggs KK, Soares E, Bhatia S, et al. Postoperative alpha angle not associated with patient-centered midterm outcomes following hip arthroscopy for FAI. Knee Surg Sports Traumatol Arthrosc. 2019;27(10):3105–9.
Lansdown DA, Kunze K, Ukwuani G, et al. The importance of comprehensive cam correction: radiographic parameters are predictive of patient-reported outcome measures at 2 years after hip arthroscopy. Am J Sports Med. 2018;46(9):2072–8.
Mansor Y, Perets I, Close MR, et al. In search of the spherical femoroplasty: cam overresection leads to inferior functional scores before and after revision hip arthroscopic surgery. Am J Sports Med. 2018;46(9):2061–71.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Section Editor information
Rights and permissions
Copyright information
© 2022 Springer Nature Switzerland AG
About this entry
Cite this entry
Byrd, J.W.T. (2022). Surgical Technique: Arthroscopic 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_59
Download citation
DOI: https://doi.org/10.1007/978-3-030-43240-9_59
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-43239-3
Online ISBN: 978-3-030-43240-9
eBook Packages: MedicineReference Module Medicine