Arthroscopy: The Journal of Arthroscopic & Related Surgery
Original ArticleMechanical Strength of the Proximal Femur After Arthroscopic Osteochondroplasty for Femoroacetabular Impingement: Finite Element Analysis and 3-Dimensional Image Analysis
Section snippets
Subjects and Data Collection
Forty-one consecutive patients who received hip arthroscopy between April 2014 and August 2016 were assessed for eligibility. Twenty-three patients with cam-type FAI remained after exclusion of 12 patients received hip arthroscopy for osteoarthritis and 6 patients with borderline developmental dysplasia of the hip (DDH) without cam deformity. A diagnosis of cam-type FAI was based on the patient's history, physical diagnostic tests (Patrick test and the anterior impingement test),13 and
Results
The characteristics of the study subjects are summarized in Table 1. The average preoperative radiographic alpha angle (61.5° ± 7.6°) was reduced significantly (to 40.6° ± 5.3°) at first postoperative week (P < .001). With respect to patient-reported outcomes, the average preoperative NAHS (64.6 ± 19.3) improved significantly (P = .0005) at the 6-month follow-up (88.1 ± 9.3). The number of subjects with a poor NAHS score (<70 points) fell from 8 (44.4%) to 1 (6.0%).
FE analyses conducted under
Discussion
To investigate the effect of the location of bone resection on the mechanical strength of proximal femur, we combined 2 different approaches: FEA and 3-dimensional image analysis using pre- and postoperative CT image data. The results of our study suggest that bone resection at the distal side of the femoral neck would be more likely to affect the femoral neck strength than bone resection at the proximal side of the femoral neck. The volume of resected bone was not significantly correlated to
Conclusions
The results of our FEA suggest that the bone resection depth measured at the head-neck junction and the transcervical reference plane correlates with fracture risk after osteochondroplasty. By contrast, bone resection at more proximal areas did not have a significant effect on the postoperative femur model strength in our FEA. The total volume of resected bone was also not significantly correlated with postoperative changes in femur model strength.
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Cited by (6)
Editorial Commentary: Fracture Risk After Arthroscopic Osteochondroplasty for Femoroacetabular Impingement—How Can We Become Better?
2018, Arthroscopy - Journal of Arthroscopic and Related SurgeryHip Impingement Location in Maximal Hip Flexion in Patients With Femoroacetabular Impingement With and Without Femoral Retroversion
2022, American Journal of Sports MedicineRisk modeling of femoral neck fracture based on geometric parameters of the proximal epiphysis
2022, World Journal of OrthopedicsAccuracy of Computer Navigation–Assisted Arthroscopic Osteochondroplasty for Cam-Type Femoroacetabular Impingement Using the Model-to-Image Registration Method
2022, American Journal of Sports MedicineThe Effect of Resection Size in the Treatment of Cam-Type Femoroacetabular Impingement in the Typical Patient With Hip Arthroscopy: A Biomechanical Analysis
2020, American Journal of Sports Medicine
See commentary on page 2387
The authors report that they have no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.