Artikel
Distance between the femoral bump resection and the enter point of the retinacular vessels into the femoral head: A CAT-Scan evaluation with 3-D reconstruction
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Veröffentlicht: | 21. Oktober 2010 |
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Gliederung
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Objective: The complete resection of the femoral bump is essential in the treatment of cam-type femoroacetabular impingement. The lesion of the retinacular vessels is possible during the resection of the most lateral portion of the femoral bump. Purpose of this study is the measurement of the distance between the limit of the resection and the enter point of the retinacular vessels into the femoral head.
Methods: During a 1 year period (October 2007–2008) we perform in 60 patients (34 males, 26 females, mean age 36,5 years) a CAT-Scan with 3-D reconstruction after arthroscopic resection of a femoral bump. During the arthroscopy the retinacular vessels were identified previous to the bump resection. In the post-op CAT-Scan the foramina’s corresponding to the enter point of the retinacular vessels into the femoral head were identified. The distance (in mm) between the most anterior foramina and the lateral limit of the bump resection was measured using Multimodality Work Place (Leonardo 3) with 3-D Reconstruction type VRT (Volume Rendering Technique). 6 month after the hip-arthroscopy a clinical evaluation was performed to exclude an avascular necrosis (AVN) of the femoral head.
Results and conclusions: The mean distance between the most anterior foramina to the lateral limit of the femoral bump was 6,1 mm with a standard deviation of 3,0 (min 1,1mm., max 17 mm.). In the clinical evaluation 6 month after arthroscopy no patient has clinical signs suggesting an avascular necrosis of the femoral head.
The complete resection of the femoral bump is possible without damaging the entry point of the retinacular vessels into the femoral head. The identification of the vessels before the arthroscopic bump resection is possible and useful. The mean distance between the limit of the resection to the vessels was 6.1 mm. No patient develops clinical signs of AVN 6 month after the hip-arthroscopy.