A Clinically Relevant Review of Hip Biomechanics

Arthroscopic view of right hip through anterior portal. An anterolateral portal is being used for instrumentation of the joint. A capsular opening has been made for access to the peripheral compartment of the hip, and a large cam-type FAI lesion is clearly seen at the anterolateral edge of the femoral head causing impingement against the adjacent acetabular labrum.

The osseous prominence is removed with an arthroscopic bur, exposing the underlying trabecular bone.

The hip is flexed, adducted, and internally rotated to evaluate for any remaining impingement against the labrum. The most superior portion of the prominence (right side of the screen) still impinges against the labral tissue.

The osteoplasty is continued with removal of the remaining source of impingement.

On subsequent inspection, the cam lesion has been completely removed and the impingement against the acetabular labrum has been resolved. Part of this video will appear in the book Surgical Techniques in Hip Arthroscopy and Joint Preservation Surgery, edited by Sekiya, Safran, Leunig, and Ranawat.