Arthroscopic Femoral Osteochondroplasty for Cam-Type Femoroacetabular Impingement: The Trough Technique

Arthroscopic osteochondroplasty has become the most common treatment for cam-type femoroacetabular impingement. However, gauging the appropriate depth and location of the femoral osteochondroplasty remains challenging, given the parallax observed from using a 70° arthroscope across multiple viewing perspectives. Consequently, reliable techniques must use a combination of arthroscopic and fluoroscopic checks and balances to assess the femoral head-neck junction to help guide bony resection. We have developed a technique for osteochondroplasty that has made the process more efficient and reliable in our hands. It involves creating a trough at the apex of the osteochondroplasty and then contouring the proximal and distal regions to re-create normal proximal femoral geometry. This article details our technique for femoral osteochondroplasty, which can be performed alone for isolated cam impingement or in concert with other intra- and extra-articular procedures to address associated hip pathology.