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Hip Arthroscopy for Subspine Impingement: Osteoplasty With Labral Repair

March 01, 2020

Contributors: Arien Lee Cherones; Kevin Khoo; Mia Smucny, MD

The anterior inferior iliac spine has variable bony morphology and is a possible source of extra-articular femoroacetabular impingement. Direct hip flexion may result in impingement of the distal anterior inferior iliac spine against the femoral neck. Anterior inferior iliac spine-mediated hip impingement, which also is referred to as subspine impingement, is similar to classic intra-articular hip impingement, such as cam and pincer morphology. Patients should be critically evaluated for hip impingement as the primary pathologic mechanism. Hip arthroscopy is a minimally invasive method to definitively manage subspine impingement and concomitant pathology, such as labral tears or cam morphology, in a single procedure. Resection of the anterior inferior iliac spine prominence increases hip flexion, decreases pain, and improves hip function. This video discusses the operating room setup, procedural approach, and management of femoroacetabular impingement from an anterior inferior iliac spine avulsion and cam morphology via hip arthroscopy. The procedure is performed by Dr. Mia Hagen at the University of Washington.

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