Hip arthroscopy, chondroplasty of the acetabulum, and femoral head osteochondroplasty (recontouring)

The patient is a 20 year old active collegiate athlete with 6 months of hip pain and difficulty with bending at the hip.

1.The standard anteroposterior radiograph of the hip shows very dysplasia of the hip based on the slighly oblique angle of the roof of the acetabulum (black lines).

2.When viewing in the hip with the arthroscope we are seeing the upper aspect of the labrum (black arrows) and the hip socket cartilage (black arrowheads). A radiofrequency probe is being brought in from the bottom of the image.

3.A motorized shaver instrument is used to debride some tearing of the socket cartilage secondary to impaction of the femoral head on this region of the hip socket. The labrum is shown in the foreground of the image on the right (black arrow)

4.Once all of the work on the cartilage of the hip socket is completed, the traction is released and the hip is bent up with the specialized leg holder. This gives us an excellent view of the femoral head as it contacts the edge of the socket. In this case, we see a very flattened femoral head and on the front (anterior) aspect (black arrow). Also, note the multiple small vessels in the hip labrum (white arrows).

5.At this point, the femoral head "bump" or area of flattening can be removed with a burr (left image). The image on the right shows the final view after recontouring of the femoral neck. The labrum is shown at the top of the image (white arrow) and the femoral neck at the bottom (black arrow).

Surgical Video Of This Case