Femoroacetabular impingement osteoplasty is any resected amount safe? A laboratory based experiment with sawbones

Loh, B.W., Stokes, C.M., Miller, B.G. and Page, Richard S. 2015, Femoroacetabular impingement osteoplasty is any resected amount safe? A laboratory based experiment with sawbones, Bone & joint journal, vol. 97-B, no. 9, pp. 1214-1219, doi: 10.1302/0301-620X.97B9.35263.

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Title Femoroacetabular impingement osteoplasty is any resected amount safe? A laboratory based experiment with sawbones
Author(s) Loh, B.W.
Stokes, C.M.
Miller, B.G.
Page, Richard S.ORCID iD for Page, Richard S. orcid.org/0000-0002-2225-7144
Journal name Bone & joint journal
Volume number 97-B
Issue number 9
Start page 1214
End page 1219
Total pages 6
Publisher British Editorial Society of Bone & Joint Surgery
Place of publication London, Eng.
Publication date 2015
ISSN 2049-4394
Summary There is an increased risk of fracture following osteoplasty of the femoral neck for cam-type femoroacetabular impingement (FAI). Resection of up to 30% of the anterolateral head–neck junction has previously been considered to be safe, however, iatrogenic fractures have been reported with resections within these limits. We re-evaluated the amount of safe resection at the anterolateral femoral head–neck junction using a biomechanically consistent model.In total, 28 composite bones were studied in four groups: control, 10% resection, 20% resection and 30% resection. An axial load was applied to the adducted and flexed femur. Peak load, deflection at time of fracture and energy to fracture were assessed using comparison groups.There was a marked difference in the mean peak load to fracture between the control group and the 10% resection group (p < 0.001). The control group also tolerated significantly more deflection before failure (p < 0.04). The mean peak load (p = 0.172), deflection (p = 0.547), and energy to fracture (p = 0.306) did not differ significantly between the 10%, 20%, and 30% resection groups.Any resection of the anterolateral quadrant of the femoral head–neck junction for FAI significantly reduces the load-bearing capacity of the proximal femur. After initial resection of cortical bone, there is no further relevant loss of stability regardless of the amount of trabecular bone resected.Based on our findings we recommend any patients who undergo anterolateral femoral head–neck junction osteoplasty should be advised to modify their post-operative routine until cortical remodelling occurs to minimise the subsequent fracture risk.
Language eng
DOI 10.1302/0301-620X.97B9.35263
Field of Research 110314 Orthopaedics
Socio Economic Objective 920116 Skeletal System and Disorders (incl. Arthritis)
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2015, British Editorial Society of Bone & Joint Surgery
Persistent URL http://hdl.handle.net/10536/DRO/DU:30077907

Document type: Journal Article
Collections: Faculty of Health
School of Medicine
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