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Hip Impingement in the Athlete: Open Approaches

Hip Impingement in the Athlete: Open Approaches. James Barsi , MD Assistant Professor of Orthopaedic Surgery Stony Brook University. Disclosures. None. Outline. Femoroacetabular Impingement The Surgical Dislocation Approach Case Study. Femoroacetabular Impingement.

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Hip Impingement in the Athlete: Open Approaches

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  1. Hip Impingement in the Athlete: Open Approaches James Barsi, MD Assistant Professor of Orthopaedic Surgery Stony Brook University

  2. Disclosures • None

  3. Outline • Femoroacetabular Impingement • The Surgical Dislocation Approach • Case Study

  4. Femoroacetabular Impingement • Abnormal morphology of the proximal femur or acetabulum resulting in abnormal contact between the femoral neck and acetabular rim during terminal motion

  5. Types of Impingement

  6. Cam Impingement

  7. Pincer Impingement Contracoup injury

  8. Clinical Presentation • Young adults • Groin Pain • Dancers

  9. Examination Internal Impingement External Impingement

  10. Images

  11. Non-operative Management • Activity modification • Physical therapy • Steroid injection

  12. Operative Management • Arthroscopy • Surgical dislocation

  13. Outline • Femoroacetabular Impingement • The Surgical Dislocation Approach • Case Study

  14. Vascular Supply to Femoral Head Retinacular vessels Deep MFCA

  15. The Approach

  16. Resection of Pincer Lesion

  17. Resection of Cam Lesion

  18. Hospital Course • Mean length of stay: 2 days • CPM machine • No active abduction of hip for 6 wks • TTWB 6 wks

  19. Complications N = 334 JBJS 2011; 93(12): 1132

  20. Outcomes • 22 professional athletes 96% return to sport @ 4yrs AJSM 2011 39(3): 544.

  21. Why Would Anyone Choose A Surgical Dislocation for FAI?

  22. Advantages • Better visualization of anatomy • Deformity • External impingement

  23. Outline • Femoroacetabular Impingement • The Surgical Dislocation Approach • Case Study

  24. Case 1 • 15 yo M with pain for past 5 yrs • Positive internal and external impingement signs

  25. Case 2 • 18 yo male complaining of chronic right hip pain. • PMH: Perthes

  26. Conclusion • Hip impingement more frequently diagnosed • Surgical dislocation useful in cases of deformity

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