Background

Femoroacetabular impingement (FAI), which is defined as a mechanical hip disorder consisting of abnormal contact between the proximal femur and the acetabulum, is a considerable problem affecting many young patients, particularly high-level athletes. In addition to causing pain, FAI has been linked to the development of early hip osteoarthritis. Many surgical treatment modalities are available for the management of FAI, including the mini-open anterior approach, all-arthroscopic decompression, or combined hip arthroscopy and mini-open decompression. Selection of a successful treatment option is based on many factors, including the size and location of the Cam lesion. Among the several available surgical techniques, mini-open Cam resection and direct labrum examination have been successfully used treat patients with FAI.

Purpose

This video demonstrates a mini-open technique for the resection of a Cam lesion in a patient with FAI.

Methods

An overview of the pathogenesis, diagnosis, and management of FAI is discussed. The case presentation of a 17-year-old boy who is a high-level athlete with bilateral hip pain is discussed. The patient was diagnosed with bilateral Cam-type FAI. Mini-open osteochondroplasty with recontouring and labral examination was performed.

Results

The procedure was successfully performed, and the bony anatomy of the proximal femur was restored. The patient was advanced through a standardized rehabilitation protocol. At 6 months postoperatively, the patient's pain had considerably improved. The patient denied any symptoms of impingement and had painless range of motion, including 120° of flexion, 15° of internal rotation, and 30° of external rotation. At last follow-up, the patient was progressing toward his goal of returning to full functional capacity, including high-level sports.

Conclusion

Surgical restoration of the anatomy of the proximal femur via the mini-open anterior approach and osteochondroplasty is a reliable treatment option for patients with Cam-type FAI. Early results suggest good to excellent radiographic and clinical outcomes.