Purpose: The purpose of this study was to evaluate the outcome of arthroscopic femoral osteochondroplasty for cam lesions of the hip with respect to the severity of acetabular chondral damage.

Methods: The study is a retrospective review of 170 patients (35 females, 135 males) who underwent surgery for symptomatic cam femoroacetabular impingement (FAI) between the years 2003 to 2008. The patients were categorized according to three different grades of chondral damage. No patients had evidence of labral pathology. Microfracture of the acetabular chondral damage was also performed when indicated. The clinical results in each grade were measured preoperatively and postoperatively with the modified Harris Hip Score (MHHS) and Non Arthritic Hip Score (NAHS).

Results: The mean follow-up time was 22 months (range 12 to 72 months). At the last follow-up, significantly better results were observed in hips with less chondral damage. The mean MHHS improved from 74.1±17.1 to 89.8±11.6 in grade 1 whereas it improved from 62.3±14.3 to 77.4±18.3 in grade 3 (p=0.02). The mean NAHS improved from 70.7±13.5 to 87±16.2 in grade 1 whereas it improved from 60.5±16.2 to 78±17.8 in grade 3 (p=0.04). Microfracture in limited zones of ace-tabular chondral damage had shown superior results.

Conclusions: Arthroscopic femoral osteoplasty for hip cam impingement with acetabular chondral damage provides a significant improvement in symptoms. Microfracture of the chondral lesion in selected cases has been demonstrated to be safe and benifical.

Femero acetabular impingement is a common casue of hip and groin pain. Its presence can be expected from clinical examination and confirmed with appropriate imaging. Treatment of the CAM lesion has been well described by Ganz et al and the open treatment of this condition has been shown to be effective. However, there is significant morbidity associoated with this surgery. Arthroscopic treatment of the CAM lesion and also pincer impingement can be safely performed and the techniques will be shown.

We will detail our experience in performing over 500 arthroscopies for femero acetabular impingement. This will be a visual demonstration of the techniques we use on a day to day basis.

We will demonstrate different degrees of rim lesions, labral tears, labral repairs, acetabular rim excision, femero osteochondroplasty, checking impingement and intra-operative techniques for confirming position of resection.

In the future this technique will be widley used to treat FAI by a greater number of surgeons.