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Surgical Technique: Open Acetabular Rim Trimming, Labral Refixation, and Open Femoral Osteochondroplasty

Hip Arthroscopy and Hip Joint Preservation Surgery: Second Edition, Page: 803-812
2022
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Book Chapter Description

Femoroacetabular impingement (FAI) can be from a cam, a pincer, or a combined deformity. This deformity can lead to pathological contact between the femoral head and the acetabulum leading to limited range of motion, pain, labral tears, cartilage damage, and eventual osteoarthritis. Recent surgical advances in hip preservation surgery allow the orthopedic surgeon to address these deformities and potentially reverse the destructive changes of FAI. Understanding the underlying pathoanatomy is important in deciding which surgical approach to use. Although arthroscopy has become the main technique to address FAI, it has limitations in visualization, amount of resection possible, location of resection, or labral repair, and outcomes are influenced by surgeon experience. Open surgical dislocation provides excellent visualization of the proximal femur and of the acetabulum and offers excellent surgical access to the hip-preserving surgeon. The open approach allows the surgeon to address all pathologies associated with FAI: acetabular rim trimming, labral reattachment, and femoral osteochondroplasty. Multiple studies have shown this technique to be effective at alleviating symptoms and providing good, long-term patient-reported outcomes while preventing the need for arthroplasty.

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