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A Probing Device for Quantitatively Measuring the Mechanical Properties of Soft Tissues during Arthroscopy
Published on: May 1, 2020
Arthroscopic cam resection reduces femoroacetabular contact pressure : a cadaver study
Pedro Dantas1,2,3, Sérgio B Gonçalves4, Sérgio R Gonçalves2,3
1NOVA Medical School, Lisbon, Portugal.
Aims:
Arthroscopic cam resection in femoroacetabular impingement syndrome leads to clinical improvement, but biomechanical studies on the effect of surgical intervention are scarce. In this study, we compared the femoroacetabular contact pressure (CP) in an intact cam morphology and after arthroscopic cam resection. The hypothesis was that arthroscopic cam resection decreases the femoroacetabular CP.
Methods:
A cadaveric study was performed on nine hips with a cam morphology (α angle > 60°). CP was assessed using a new hip-specific device and an intracranial pressure (ICP) sensor. These evaluations were performed during hip arthroscopy, in the intact joint and after cam resection, with the joint in different positions. These measurements were normalized and reported as a percentage of the native intact joint.
Results:
A statistically significant difference in the mean CP measured with the hip-specific device was observed before and after cam osteoplasty at 0° (41.2% (SD 29.7%); p = 0.014), 30° (54.5% (SD 16.6%); p = 0.011), 60° (39.8% (SD 23.0%); p < 0.001), 80° of flexion (36.3% (SD 22.1%); p < 0.001), and 80° of flexion with 20° of internal rotation (26.0% (SD 22.4%); p < 0.001). The ICP sensor is very fragile and difficult to handle in hip arthroscopy. Consequently, we limited the evaluations using this sensor to five hips. A statistically significant difference in the CP was found before and after cam osteoplasty at 80° of flexion (57.6% (SD 29.1%); p = 0.004).
Conclusion:
This biomechanical study evaluated a new hip-specific device to intraoperatively measure the CP in arthroscopic surgery. It showed a significant decrease in the CP after arthroscopic cam resection with the joint in different positions. At 80° of flexion with 20° of internal rotation, a typical position to detect hip impingement, the CP was reduced to 26% after arthroscopic cam resection. The intraoperative measurement of CP provides surgeons with feedback to evaluate the effectiveness of the osteoplasty.
