Arthroscopy. 2022 Apr;38(4):1164-1165. doi: 10.1016/j.arthro.2021.11.038.
The perfect femoroplasty varies with the individual patient's pathoanatomy and is a prime example of the art and science of surgery. Radiographs are two-dimensional representations of a three-dimensional reality and can miss detection of cam impingement. Cam impingement may occur without cam morphology as femoral retrotorsion and/or supraphysiological range of motion (e.g., dancers and martial artists) may cause cam impingement with normal α-angles and anterior offset. Acetabuloplasty or acetabular reorientation osteotomy may change the dynamic interaction between the proximal femur and acetabular rim and may alter the location and extent of cam decompression. Although much is discussed about the α-angle, restoration of anterior offset is also important. Incremental femoroplasty assessed in real time by arthroscopic dynamic examination is key, as the surgeon sculpts a nonimpinging proximal femur using a burr rather than a chisel in creating a customized surgical masterpiece.
完美的股骨成形术因个体患者的病理解剖结构而异，是手术艺术和科学的典范。射线照片是三维现实的二维表示，可能会漏诊凸轮撞击。凸轮撞击可能发生在没有凸轮形态的情况下，因为股骨后旋和/或超生理运动范围（例如，舞者和武术家）可能导致正常 α 角和前偏移的凸轮撞击。髋臼成形术或髋臼再定位截骨术可能改变股骨近端和髋臼边缘之间的动态相互作用，并可能改变凸轮减压的位置和程度。尽管人们对 α 角进行了大量讨论，但恢复前偏移也很重要。关节镜动态检查实时评估的增量股骨成形术至关重要，因为外科医生使用钻头而不是凿子来雕刻无撞击的股骨近端，从而创造出定制的手术杰作。
