Purpose of the study: The purpose of this work was to search for a relationship between the size of the femoral cam, the presence of cup retroversion, and the presence of labral or chondral lesions on the arthroscan in patients with an asymptomatic femoroacetabular impingement.

Material and method: Fifty arthroscans were obtained to explore impingements. The patients complained of groin or trochanteric pain limiting their physical activities. Generally signs of an anterosuperior impingement were demonstrated with flexion-adduction-internal rotation. The localization, dimensions and depth of the cartilage lesions were measured on the arthroscan. The sagittal slice was used to describe the acetabular chondral lesions anteriorly to posteriorly in clockwise manner. Presence of an associated labral lesion was noted. A second operator measured the hip joint anomalies causing the impingement: Notzli’s alpha angle was measured to search for a cam effect and the femoral offset was noted.

Results: The presence of a femoral cam or a decreased femoral offset were found in all cases. Mean alpha angle was 65°; mean offset was 0.09. Acetabular retroversion was identified in 24 patients (48%). Chondral lesions were a constant finding and were superficial (type 1& 2) in 32 patients (64%) and deep (type 3& 4) in 18 patients (36%). Labral lesions were found in 28 patients (56%). The depth of the chondral lesions, like the presence of a labral lesion, were correlated significantly with increased alpha angle and patient age. There was conversely no correlation with the presence of acetabular retroversion.

Discussion: This study confirmed the close relationship between femoroacetabular impingement by a cam effect and the severity of labral lesions and acetabular cartilage lesions. These lesions can favour degeneration, explaining the early centred or posterinferior damage observed in young patients with satisfactory acetabular cover.

Introduction: Patient education and informed consent are areas of clinical practice that are taking an ever-increasing proportion of a surgeon’s time and effort. The expectation is that this trend will continue, as medical malpractice litigation becomes more commonplace. Patients are also requiring increased access to medical information to help facilitate decisions about their healthcare. With the increasing use of computers and improvements in technology modules to aid patients’ understanding have become available and may prove useful in patient education.

Method: A computer-based multimedia module of total hip replacement (THR) has been developed. These involve three-dimensional (3D), animated computer graphics with text and spoken word. A questionnaire based on educational models was designed to test ease of use and patients’ comprehension after viewing the module.

Results: A pilot study involved 20 patients each awaiting elective surgery for THR. The results showed a good comprehension and understanding of the nature of the surgery and the possible complications.

Conclusions: We have shown that a 3D-multimedia patient education module improved patients’ understanding of THR surgery and its possible complications. The use of 3D multimedia modules has the potential to save the surgeon time whilst ensuring that his/her patients have given informed consent to their forthcoming surgery. It is hoped that better-informed consent may equate to a reduction in medical malpractice activity and thus insurance premiums.