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Chapter 11 Video 1: 17-Year-Old Male Ice Hockey Goaltender with Persistent Left Hip Pain

August 01, 2016

Contributors: Marc J Philippon, MD

This is a case of a 17 year old male high level ice hockey goal tender with persistent left hip pain. The patient was found to have femoral acetabular impingement as a result of cam morphology of the proximal femur. This pain failed to improve with non-operative management. The patient is placed supine on the operating table. Anterolateral and mid anterior portals are used, and a capsulotomy is performed. A 5.5mm burr is used to resect the cam lesion at the femoral head/neck junction. A gentle slope, similar to a blue ski run is aimed for. The slope should not be too steep, like a black diamond run, or too shallow, like a green circle run. Osteoplasty resection is carried out from the 12 o'clock position to the 6 o'clock position on the acetabular clock face, until there is a smooth concavity and reestablishment of the appropriate offset. A subchondral cyst is seen here. The lateral epiphyseal vessels are identified and protected throughout the resection. A dynamic examination is performed to assess for residual impingement, and impingement is not found. Any focal residual impingement can be trimmed at this point. The hip fluid seal has been reestablished.

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