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Ultrasonography can quantify the extent of osteochondroplasty after treatment of Cam-type femoroacetabular impingement

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Abstract

Purpose

Surgical resection of femoroacetabular Cam impingement (cam-FAI) is now a generally accepted treatment, producing adequate hip score increases. Insufficient resection at the head–neck junction is the main reason for revision. The anterolateral region of the head–neck junction is visualized only suboptimally by radiography, which can be inadequate for monitoring resection results postoperatively. Our aim was to investigate the extent of Cam resection by ultrasonography (US) and determine if there is any correlation with clinical outcome.

Methods

Altogether, 40 consecutive patients (mean age 39 years) were enrolled in this prospective study following arthroscopic Cam resection. All patients underwent standardized US examination in the ventral longitudinal section at 20° external rotation, neutral position, and 20° internal rotation the day before arthroscopy and two days afterward. Alpha angle, anterior offset, offset ratio, and anterior femoral distance were measured on sonograms. Hip Disability and Osteoarthritis Outcome Score (HOOS) and Western Ontario and McMaster University Index of Osteoarthritis (WOMAC) were conducted the day before surgery and 6 weeks postoperatively (at the earliest).

Results

Alpha angle was significantly smaller on postoperative US in all hip joint positions. At 20° internal rotation, the alpha angle decreased from 65.6 to 36.9° (p < 0.0001). All but two (5 %) patients had alpha angles <50°. Anterior offset increased significantly on US in neutral position and at 20° internal rotation. HOOS and WOMAC increased significantly. No correlation was found between measurements for Cam-FAI and the scores.

Conclusions

US may be a useful tool for monitoring Cam-FAI resection results postoperatively.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Clinic for Orthopaedics/Traumatology/Sports Medicine, Klinikum Agnes Karll Laatzen/Klinikum Region Hannover, Hildesheimer Str. 158, 30880, Laatzen, Germany

    Solveig Lerch, Thomas Berndt & Oliver Rühmann

  2. Clinic for Radiology and Nuclear Medicine, Hildesheimer Str. 158, 30880, Laatzen, Germany

    Andreas Kasperczyk

Authors
  1. Solveig Lerch
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  2. Andreas Kasperczyk
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  3. Thomas Berndt
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  4. Oliver Rühmann
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Correspondence to Solveig Lerch.

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Lerch, S., Kasperczyk, A., Berndt, T. et al. Ultrasonography can quantify the extent of osteochondroplasty after treatment of Cam-type femoroacetabular impingement. International Orthopaedics (SICOT) 39, 853–858 (2015). https://doi.org/10.1007/s00264-014-2588-3

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  • DOI: https://doi.org/10.1007/s00264-014-2588-3

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