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Arthroscopic labral debridement
12%
7/59
Reverse periacetabular osteotomy
0%
0/59
Resurfacing hip arthroplasty
2%
1/59
Femoral neck osteochondroplasty and resection of the detached labrum
17%
10/59
Femoral neck osteochondroplasty and reattachment of the labrum
64%
38/59
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The patient has cam-type femoral acetabular impingement. He still has a well-maintained joint space without significant degenerative changes, and given his age a joint preserving procedure would be the procedure of choice. A reverse periacetabular osteotomy may be considered in a retroverted acetabulum; however, that is not the case here. A femoral neck osteochondroplasty is required to remove the cam of bone and reshape the femoral head-neck junction to improve the femoral head/neck ratio (femoral head offset). Typically, in isolated cam impingement, cartilage damage in the anterior-superior acetabulum precedes labral damage. Labral debridement alone does not address the pathology of impingement. In cases where labral detachment is present, reattachment has been shown to be superior to labral resection.
4.7
(3)
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