Advertisement

Osteochondroplasty and Acetabular Rim Trimming by Surgical Hip Dislocation for Femoroacetabular Impingement

  • Benjamin D. Martin
  • Matthew E. Oetgen
Chapter

Abstract

Femoroacetabular impingement is typically a combination of cam- and pincer-type impingement. The surgical hip dislocation approach described by Ganz allows for 360° access to the femoral head and acetabulum for osteochondroplasty, acetabular rim trimming, and labral repair. The cam lesion is removed to restore sphericity and offset of the head-neck junction. The edge of the acetabulum can be resected, or trimmed, to address acetabular over-coverage, and areas of cartilage and labral damage due to the cam lesion can be repaired, resected, or treated with microfracture, as needed. To accomplish this, the labrum must be detached from the acetabular rim and later repaired back to reconstruct this anatomic structure. Intraoperative assessment is essential to confirm that all aspects of the impingement are addressed by observing the femoral head and the labrum as the hip is taken through a range of motion.

Keywords

Osteochondroplasty Cam lesion Pincer impingement Surgical hip dislocation Labral repair 

Notes

Acknowledgment

The authors would like to thank Daniel J. Sucato MD, MS, and Neil Saran MD for their help in supplying images for this chapter.

Suggested Reading

  1. Anwander H, Siebenrock KA, Tannast M, Steppacher SD. Labral reattachment in femoroacetabular impingement surgery results in increased 10-year survivorship compared with resection. Clin Orthop Relat Res. 2017;475(4):1178–88.CrossRefGoogle Scholar
  2. Espinosa N, Beck M, Rothenfluh DA, Ganz R, Leunig M. Treatment of femoro-acetabular impingement: preliminary results of labral refixation. Surgical technique. J Bone Joint Surg Am. 2007;89(Suppl 2, Pt 1):36–53.CrossRefGoogle Scholar
  3. Espinosa N, Rothenfluh DA, Beck M, Ganz R, Leunig M. Treatment of femoro-acetabular impingement: preliminary results of labral refixation. J Bone Joint Surg Am. 2006;88(5):925–35.PubMedGoogle Scholar
  4. Ganz R, Gill TJ, Gautier E, Ganz K, Krugel N, Berlemann U. Surgical dislocation of the adult hip a technique with full access to the femoral head and acetabulum without the risk of avascular necrosis. J Bone Joint Surg Br. 2001;83(8):1119–24.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Orthopaedic Surgery and Sports MedicineChildren’s National Health SystemWashingtonUSA
  2. 2.The George Washington University School of Medicine and Health SciencesWashingtonUSA

Personalised recommendations