Computer-Assisted Hip Arthroscopic Surgery for Secondary Femoroacetabular Impingement After Rotational Acetabular Osteotomy Using Capsular Takedown Techniques

Secondary femoroacetabular impingement (FAI) is a severe complication observed after acetabular osteotomy; however, the diagnostic and treatment strategies of FAI have not been well established, especially with respect to arthroscopic techniques. We here describe hip arthroscopic osteochondroplasty...

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Main Authors: Shota Higashihira, M.D., Ph.D., Yohei Yukizawa, M.D., Ph.D., Ayahiro Kadowaki, M.D., Shu Takagawa, MD., Ph.D., Hyonmin Choe, M.D., Ph.D., Yutaka Inaba, M.D., Ph.D., Naomi Kobayashi, M.D., Ph.D.
Format: Article
Language:English
Published: Elsevier 2025-02-01
Series:Arthroscopy Techniques
Online Access:http://www.sciencedirect.com/science/article/pii/S2212628724003268
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author Shota Higashihira, M.D., Ph.D.
Yohei Yukizawa, M.D., Ph.D.
Ayahiro Kadowaki, M.D.
Shu Takagawa, MD., Ph.D.
Hyonmin Choe, M.D., Ph.D.
Yutaka Inaba, M.D., Ph.D.
Naomi Kobayashi, M.D., Ph.D.
author_facet Shota Higashihira, M.D., Ph.D.
Yohei Yukizawa, M.D., Ph.D.
Ayahiro Kadowaki, M.D.
Shu Takagawa, MD., Ph.D.
Hyonmin Choe, M.D., Ph.D.
Yutaka Inaba, M.D., Ph.D.
Naomi Kobayashi, M.D., Ph.D.
author_sort Shota Higashihira, M.D., Ph.D.
collection DOAJ
description Secondary femoroacetabular impingement (FAI) is a severe complication observed after acetabular osteotomy; however, the diagnostic and treatment strategies of FAI have not been well established, especially with respect to arthroscopic techniques. We here describe hip arthroscopic osteochondroplasty for secondary FAI using computer-assisted techniques. The main features and tips of our technique are preoperative computed tomography (CT)-based surgical planning and the intraoperative capsule takedown method. Computer modeling produces a patient-specific 3-dimensional CT bone model. Subsequently, we identify the impingement point between the acetabulum and the femoral neck using dynamic simulation. The excess bony bumps are resected through computer surgical simulation, and pre- and postoperative 3-dimensional CT bone models are combined to identify the appropriate resection area. For the surgical technique, it is important to detach the capsule to visualize the acetabulum bony excess. Once the resection area has been sufficiently visualized, the bone resection is performed. Finally, the capsule is reattached to the excavated acetabulum, and the delaminated labrum is sewn up with the capsule in a round bale shape.
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spelling doaj-art-91d4df44dc2e417e9a8662cbee39de0b2025-08-20T02:13:27ZengElsevierArthroscopy Techniques2212-62872025-02-0114210319310.1016/j.eats.2024.103193Computer-Assisted Hip Arthroscopic Surgery for Secondary Femoroacetabular Impingement After Rotational Acetabular Osteotomy Using Capsular Takedown TechniquesShota Higashihira, M.D., Ph.D.0Yohei Yukizawa, M.D., Ph.D.1Ayahiro Kadowaki, M.D.2Shu Takagawa, MD., Ph.D.3Hyonmin Choe, M.D., Ph.D.4Yutaka Inaba, M.D., Ph.D.5Naomi Kobayashi, M.D., Ph.D.6Department of Orthopaedic Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, JapanDepartment of Orthopaedic Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, JapanDepartment of Orthopaedic Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, JapanDepartment of Orthopaedic Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, JapanDepartment of Orthopaedic Surgery, Yokohama City University, Yokohama, Kanagawa, JapanDepartment of Orthopaedic Surgery, Yokohama City University, Yokohama, Kanagawa, JapanDepartment of Orthopaedic Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Address correspondence to Naomi Kobayashi, M.D., Ph.D., Department of Orthopaedic Surgery, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa, Japan 232-0024.Secondary femoroacetabular impingement (FAI) is a severe complication observed after acetabular osteotomy; however, the diagnostic and treatment strategies of FAI have not been well established, especially with respect to arthroscopic techniques. We here describe hip arthroscopic osteochondroplasty for secondary FAI using computer-assisted techniques. The main features and tips of our technique are preoperative computed tomography (CT)-based surgical planning and the intraoperative capsule takedown method. Computer modeling produces a patient-specific 3-dimensional CT bone model. Subsequently, we identify the impingement point between the acetabulum and the femoral neck using dynamic simulation. The excess bony bumps are resected through computer surgical simulation, and pre- and postoperative 3-dimensional CT bone models are combined to identify the appropriate resection area. For the surgical technique, it is important to detach the capsule to visualize the acetabulum bony excess. Once the resection area has been sufficiently visualized, the bone resection is performed. Finally, the capsule is reattached to the excavated acetabulum, and the delaminated labrum is sewn up with the capsule in a round bale shape.http://www.sciencedirect.com/science/article/pii/S2212628724003268
spellingShingle Shota Higashihira, M.D., Ph.D.
Yohei Yukizawa, M.D., Ph.D.
Ayahiro Kadowaki, M.D.
Shu Takagawa, MD., Ph.D.
Hyonmin Choe, M.D., Ph.D.
Yutaka Inaba, M.D., Ph.D.
Naomi Kobayashi, M.D., Ph.D.
Computer-Assisted Hip Arthroscopic Surgery for Secondary Femoroacetabular Impingement After Rotational Acetabular Osteotomy Using Capsular Takedown Techniques
Arthroscopy Techniques
title Computer-Assisted Hip Arthroscopic Surgery for Secondary Femoroacetabular Impingement After Rotational Acetabular Osteotomy Using Capsular Takedown Techniques
title_full Computer-Assisted Hip Arthroscopic Surgery for Secondary Femoroacetabular Impingement After Rotational Acetabular Osteotomy Using Capsular Takedown Techniques
title_fullStr Computer-Assisted Hip Arthroscopic Surgery for Secondary Femoroacetabular Impingement After Rotational Acetabular Osteotomy Using Capsular Takedown Techniques
title_full_unstemmed Computer-Assisted Hip Arthroscopic Surgery for Secondary Femoroacetabular Impingement After Rotational Acetabular Osteotomy Using Capsular Takedown Techniques
title_short Computer-Assisted Hip Arthroscopic Surgery for Secondary Femoroacetabular Impingement After Rotational Acetabular Osteotomy Using Capsular Takedown Techniques
title_sort computer assisted hip arthroscopic surgery for secondary femoroacetabular impingement after rotational acetabular osteotomy using capsular takedown techniques
url http://www.sciencedirect.com/science/article/pii/S2212628724003268
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