How accurately can the acetabular rim be trimmed in hip arthroscopy for pincer-type femoral acetabular impingement: a cadaveric investigation

Zumstein, M; Hahn, F; Sukthankar, A; Sussmann, PS; Dora, C (2009). How accurately can the acetabular rim be trimmed in hip arthroscopy for pincer-type femoral acetabular impingement: a cadaveric investigation. Arthroscopy - the journal of arthroscopic & related surgery, 25(2), pp. 164-8. Philadelphia, Pa.: Elsevier 10.1016/j.arthro.2008.09.016

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PURPOSE: The purpose of this study was to evaluate the precision of central hip arthroscopy in the assessment and treatment of pincer-type femoroacetabular impingement (FAI) avoiding the posterolateral portal, with its close proximity to the main arterial blood supply of the femoral head, the medial circumflex femoral artery. METHODS: Seven human cadaveric hips underwent arthroscopic trimming of the acetabular labrum and rim along a preoperatively defined 105 degrees arc of resection for treatment of a presumed pincer-type lesion. After the arthroscopic procedure, all specimens were dissected and measured for evaluation of the location, quantity, and quality of the area undergoing resection. RESULTS: The difference between the actual and planned arc of resection was 18.7 degrees +/- 4.7 degrees (range, 2 degrees to 34 degrees). This was mainly because of a lack of accuracy in the presumed posterior starting point (PSP), with a mean deviation of 19 degrees +/- 3.4 degrees (range, 10 degrees to 36 degrees). Correlation analysis showed that variance in the arc of resection was mainly dependent on the PSP (r = 0.739, P = .058). CONCLUSIONS: Central hip arthroscopy is a feasible option in treating anterosuperior pincer-type FAI by use of the anterior and anterolateral portals only. This cadaveric study showed that there is a significant risk of underestimating the actual arc of resection compared with the planned arc of resection for posterosuperior pincer-type lesions because of the modest accuracy in determining the PSP of the resection. CLINICAL RELEVANCE: Accurate preoperative planning and arthroscopic identification of anatomic landmarks at the acetabular side are crucial for the definition of the appropriate starting and ending points in the treatment of pincer-type FAI. Whereas anterosuperior pincer-type lesions can be addressed very precisely with our technique, the actual resection of posterosuperior lesions averaged 19 degrees less than the planned resection, which may have clinical implications.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery
UniBE Contributor:	Zumstein, Matthias
ISSN:	0749-8063
ISBN:	19171276
Publisher:	Elsevier
Language:	English
Submitter:	Factscience Import
Date Deposited:	04 Oct 2013 15:09
Last Modified:	05 Dec 2022 14:21
Publisher DOI:	10.1016/j.arthro.2008.09.016
PubMed ID:	19171276
Web of Science ID:	000263641300009
URI:	https://boris.unibe.ch/id/eprint/30381 (FactScience: 193038)