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Subspine Impingement and Surgical Technique

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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 articular cartilage damage via mechanical overload that may lead to the development of early osteoarthritis. However, other causes of impingement have been described that may be associated with painful nonarthritic hip. Subspine impingement is caused by abnormal contact between the AIIS (anterior inferior iliac spine) and proximal femur with straight hip flexion. 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. Arthroscopic subspine decompression has provided good to excellent patient-reported outcomes. 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, NYU Langone Medical Center, NYU Langone Orthopedic Hospital, New York, NY, USA

    Lazaros A. Poultsides

  2. Department of Orthopaedic Surgery, Center for Hip Preservation Surgery, Hospital for Special Surgery, New York, NY, USA

    Benedict U. Nwachukwu & Bryan T. Kelly

  3. Weill Medical College of Cornell University, New York, NY, USA

    Benedict U. Nwachukwu & Bryan T. Kelly

Authors
  1. Lazaros A. Poultsides
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  2. Benedict U. Nwachukwu
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  3. Bryan T. Kelly
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Corresponding author

Correspondence to Benedict U. Nwachukwu .

Editor information

Editors and Affiliations

  1. Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA

    Shane J. Nho

  2. Department of Orthopedic Surgery, University of Michigan, Ann Arbor, MI, USA

    Bedi Asheesh

  3. Department of Orthopedic Surgery, Case Western Reserve University, Cleveland, OH, USA

    Michael J. Salata

  4. Department of Orthopedic Surgery, Duke Medical Center, Durham, NC, USA

    Richard C. Mather III

  5. Department of Orthopedic Surgery, Weill Medical College of Cornell Univers, New York, NY, USA

    Bryan T. Kelly

Section Editor information

  1. Houston Methodist Center for Orthopaedics & Sports Medicine, Houston, TX, USA

    Joshua D. Harris

  2. Rush University Medical Center, Chicago, IL, USA

    Joshua D. Harris

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Poultsides, L.A., Nwachukwu, B.U., Kelly, B.T. (2021). Subspine Impingement and Surgical Technique. In: Nho, S.J., Asheesh, B., Salata, M.J., Mather III, R.C., Kelly, B.T. (eds) Hip Arthroscopy and Hip Joint Preservation Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7321-3_68-2

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

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Chapter history

  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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