Elsevier

The Journal of Arthroplasty

Volume 23, Issue 2, February 2008, Pages 226-234
The Journal of Arthroplasty

Original Article
Arthroscopic Treatment of Cam-Type Femoroacetabular Impingement: Preliminary Report at 2 Years Minimum Follow-Up

https://doi.org/10.1016/j.arth.2007.03.016Get rights and content

Abstract

Femoroacetabular impingement is defined as anterior hip abutment between the acetabular rim and proximal femur. When it is secondary to acetabular overcoverage, it is pincer impingement. When it is secondary to femoral head and neck deformity, it is cam impingement. Open remodeling of impinging deformities is the standard treatment of this condition. We describe arthroscopic treatment of cam impingement in 19 patients using standard hip arthroscopy portals by the lateral approach. Sixteen patients improved their symptoms after the procedure; and 3 patients deteriorated, with 1 needing a total hip arthroplasty at 2 years follow-up. We had no cases with postoperative femoral neck fractures or avascular necrosis. Hip arthroscopy can be successfully used to treat cam impingement. The precautions used in open surgery to preserve femoral neck bone stock and hip vascularity should be followed.

Section snippets

Methods

A consecutive series of patients with the diagnosis of cam FAI treated with arthroscopic proximal femur reshaping was prospectively studied with a minimum follow-up of 2 years. Patients that presented an impingement deformity dependent on the acetabulum such as coxa profunda, acetabular retroversion, or acetabular deformity secondary to osteotomy (iatrogenic impingement) belong to the pincer FAI classification. Pincer FAI cases were not included in this study. Patients that presented a pincer

Results

Between January 2003 and June 2004, we performed 19 hip arthroscopies in 19 patients for cam-type FAI with unilateral disease (Table 1). We had 11 male and 8 female patients with an average age of 34 years (range 27-43). Twelve hips were right and 7 left. All the patients complained of pain in the groin related to physical activity and presented limited internal rotation with pain. They also complained of occasional mechanical hip symptoms (locking and catching of the hip joint). Cam-type

Discussion

Anatomic deformity has been described as an important etiology of hip osteoarthritis [1]. Leunig et al have made significant contributions in the description and treatment of FAI and its relation with hip osteoarthritis [3]. More recent developments have made hip arthroscopy a very attractive alternative in the treatment of FAI 5, 6. These developments are so new that the techniques are evolving as more experience is gained.

Beck et al [14] reported the results of open treatment of cam FAI in 19

Acknowledgments

We want to thank Dr. Saul Renan Leon for his help with statistical analysis.

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No benefits or funds were received in support of this study.

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