Skip to main content
Log in

Arthroscopic Femoroplasty in the Management of Cam-type Femoroacetabular Impingement

  • Symposium: Femoroacetabular Impingement: Current Status of Diagnosis and Treatment
  • Published:
Clinical Orthopaedics and Related Research

Abstract

Cam-type femoroacetabular impingement is a recognized cause of intraarticular pathology and secondary osteoarthritis in young adults. Arthroscopy is reportedly useful to treat selected hip abnormalities and has been proposed as a method of correcting underlying impingement. We report the outcomes of arthroscopic management of cam-type femoroacetabular impingement. We prospectively assessed all 200 patients (207 hips) who underwent arthroscopic correction of cam impingement from December 2003 to October 2007, using a modified Harris hip score. The minimum followup was 12 months (mean, 16 months; range, 12–24 months); no patients were lost to followup. The average age was 33 years with 138 men and 62 women. One hundred and fifty-eight patients (163 hips) underwent correction of cam impingement (femoroplasty) alone while 42 patients (44 hips) underwent concomitant correction of pincer impingement. The average increase in Harris hip score was 20 points; 0.5% converted to THA. We had a 1.5% complication rate. The short-term outcomes of arthroscopic treatment of cam-type femoroacetabular impingement are comparable to published reports for open methods with the advantage of a less invasive approach.

Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1A–B
Fig. 2A–G
Fig. 3A–G
Fig. 4

Similar content being viewed by others

References

  1. Beaulé PE, Le Duff MJ, Zaragoza E. Quality of life following femoral head-neck osteochondroplasty for femoroacetabular impingement. J Bone Joint Surg Am. 2007;89:773–779.

    Article  PubMed  Google Scholar 

  2. Beck M, Leunig M, Parvizi J, Boutier V, Wyss D, Ganz R. Anterior femoroacetabular impingement: part II. Midterm results of surgical treatment. Clin Orthop Relat Res. 2004;418:67–73.

    Article  PubMed  Google Scholar 

  3. Byrd JW. Hip arthroscopy utilizing the supine position. Arthroscopy. 1994;10:275–280.

    PubMed  CAS  Google Scholar 

  4. Byrd JW. Hip arthroscopy: evolving frontiers. Op Tech Orthop. 2004;14:58–67.

    Article  Google Scholar 

  5. Byrd JW, Jones KS. Prospective analysis of hip arthroscopy with two year follow up. Arthroscopy. 2000;16:578–587.

    PubMed  CAS  Google Scholar 

  6. Byrd JW, Jones KS. Prospective analysis of hip arthroscopy with five year follow up. Arthroscopy. 2003;19:88.

    Article  Google Scholar 

  7. Byrd JW, Jones KS. Diagnostic accuracy of clinical assessment, MRI, gadolinium MRI, and intraarticular injection in hip arthroscopy patients. Am J Sports Med. 2004;32:1668–1674.

    Article  PubMed  Google Scholar 

  8. Byrd JWT. Indications and contraindications. In: Byrd JWT, ed. Operative Hip Arthroscopy. New York, NY: Thieme; 1998:7–24.

    Google Scholar 

  9. Byrd JWT. Arthroscopy of select hip lesions. In: Byrd JWT, ed. Operative Hip Arthroscopy. New York, NY: Thieme; 1998:153–170.

    Google Scholar 

  10. Byrd JWT. The supine approach. In: Byrd JWT, ed. Operative Hip Arthroscopy. 2nd ed. New York, NY: Springer; 2005:145–169.

    Google Scholar 

  11. Byrd JWT. Hip arthroscopy: the supine position. In: Ireland ML, ed. Instructional Course Lectures Sports Medicine. Rosemont, IL: American Academy of Orthopaedic Surgeons; 2005:235–244.

    Google Scholar 

  12. Byrd JWT. Hip morphology and related pathology. In: Johnson DH, Pedowitz RA, ed. Practical Orthopaedic Sports Medicine and Arthroscopy. Philadelphia, PA: Lippincott Williams & Wilkins; 2007:491–503.

    Google Scholar 

  13. Ganz R, Parvizi J, Beck M, Leunig M, Notzli H, Siebenrock KA. Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res. 2003;417:112–120.

    PubMed  Google Scholar 

  14. Garceau GJ. Surgical treatment of coxa plana. J Bone Joint Surg Br. 1964;46:779–780.

    Google Scholar 

  15. Heyman CH, Herndon CH. Slipped femoral epiphysis with severe displacement: a conservative operative treatment. J Bone Joint Surg Am. 1957;39:293–413.

    PubMed  Google Scholar 

  16. Lavigne M, Parvizi J, Beck M, Siebenrock KA, Ganz R, Leunig M. Anterior femoroacetabular impingement: part I. Techniques of joint preserving surgery. Clin Orthop Relat Res. 2004;418:61–66.

    Article  PubMed  Google Scholar 

  17. Murphy S, Tannast M, Kim YJ, Buly R, Millis MD. Debridement of the adult hip for femoroacetabular impingement: indications and preliminary clinical results. Clin Orthop Relat Res. 2004;429:178–181.

    Article  PubMed  Google Scholar 

  18. Myers SR, Eijer H, Ganz R. Anterior femoroacetabular impingement after periacetabular osteotomy. Clin Orthop Relat Res. 1999;363:81–92.

    Article  Google Scholar 

  19. Outerbridge R. Etiology of chondromalacia patella. J Bone Joint Surg Br. 1961;43:752–754.

    PubMed  Google Scholar 

  20. Peters CL, Erickson JA. Treatment of femoro-acetabular impingement with surgical dislocation and débridement in young adults. J Bone Joint Surg Am. 2006;88:1735–1741.

    Article  PubMed  Google Scholar 

  21. Smith-Petersen MN. Treatment of malum coxae senilis, old slipped upper femoral epiphysis, intrapelvic protrusion of the acetabulum, and coxa plana by means of acetabuloplasty. J Bone Joint Surg Am. 1936;18:869–880.

    Google Scholar 

  22. Steadman JR, Rodkey WG, Rodrigo JJ. Microfracture: surgical technique and rehabilitation to treat chondral defects. Clin Orthop Relat Res. 2001;391(Suppl):S362–S369.

    Google Scholar 

  23. Stulberg SD, Cordell LD, Harris WH, Ramsey PL, MacEwen GD. Unrecognized childhood hip disease: a major cause of idiopathic osteoarthritis of the hip. In: The Hip: Proceedings of the Third Open Scientific Meeting of the Hip Society. St. Louis, MO: CV Mosby; 1975:212–228.

  24. Vulpius O, Stöffel A. Orthopäadische Operationslehre. Stuttgart, Germany: F. Enke; 1913.

    Google Scholar 

  25. Wright JG, Young NL. A comparison of different indices of responsiveness. J Clin Epidemiol. 1997;50:239–246.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

We thank Sharon Simmons for her input and diligence in the preparation of the manuscript.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to J. W. Thomas Byrd MD.

Additional information

One of the authors (JWTB) is a consultant for Smith & Nephew Endoscopy, Andover, MA, and has received funding for this study from Smith & Nephew Endoscopy.

Each author certifies that his or her institution has approved or waived approval for the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

About this article

Cite this article

Byrd, J.W.T., Jones, K.S. Arthroscopic Femoroplasty in the Management of Cam-type Femoroacetabular Impingement. Clin Orthop Relat Res 467, 739–746 (2009). https://doi.org/10.1007/s11999-008-0659-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11999-008-0659-8

Keywords

Navigation