Achieving a Perfectly Spherical Femoroplasty: Pearls, Pitfalls, and Optimal Surgical Technique
Authors: Lall AC, Annin S, Chen JW, Maldonado DR, Rosinsky PJ, Shapira J, Walker-Santiago R, Domb BG
DOI: 10.1016/j.eats.2019.10.011
Background
Cam-type femoroacetabular impingement results from an aspherical femoral head, leading to abnormal joint contact and damage. Achieving a spherical femoral head through femoroplasty is vital for restoring normal joint mechanics.
Methods
This technical note outlines best practices for arthroscopic femoroplasty, highlighting methods for accurate bone resection and intraoperative assessment to avoid under- or over-correction. Emphasis is placed on 3D anatomic restoration and avoiding contour irregularities.
Key Findings
- Precision in femoroplasty is critical—over-resection can cause instability, and under-resection can result in persistent impingement.
- The authors provide step-by-step surgical tips and radiographic guidance to achieve a consistent, spherical result.
Conclusions
Meticulous execution of femoroplasty enhances postoperative results by reducing complications and improving femoral head sphericity—key to joint preservation and function.
What Does This Mean for Providers?
In the surgical management of cam-type FAI, precise femoroplasty is paramount. Using objective intraoperative techniques and advanced imaging can improve femoral head sphericity and reduce revision rates. Providers should aim for anatomic restoration over aggressive resection, particularly in high-demand or young patients.