Osteochondroplasty and Acetabular Rim Trimming by Surgical Hip Dislocation for Femoroacetabular Impingement
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.
KeywordsOsteochondroplasty Cam lesion Pincer impingement Surgical hip dislocation Labral repair
The authors would like to thank Daniel J. Sucato MD, MS, and Neil Saran MD for their help in supplying images for this chapter.
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