Myers et al. describe a case series of five patients who developed anterior femoroacetabular impingement after technically successful Bernese periacetabular osteotomy, asking why some patients have persistent pain and restricted motion despite correct acetabular repositioning.
Before PAO, scrutinize the anterior head-neck junction on radiograph and MRI for cam morphology (non-spherical head, short neck, reduced head-neck ratio) — correcting acetabular undercoverage unmasks this mismatch.
Incorporate intraoperative flexion/internal rotation stress testing after acetabular repositioning and perform concurrent anterior neck osteoplasty when impingement is identified, because soft-tissue release alone will not suffice.
Myers et al. describe a case series of five patients who developed anterior femoroacetabular impingement after technically successful Bernese periacetabular osteotomy, asking why some patients have persistent pain and restricted motion despite correct acetabular repositioning.
Before PAO, scrutinize the anterior head-neck junction on radiograph and MRI for cam morphology (non-spherical head, short neck, reduced head-neck ratio) — correcting acetabular undercoverage unmasks this mismatch.
Incorporate intraoperative flexion/internal rotation stress testing after acetabular repositioning and perform concurrent anterior neck osteoplasty when impingement is identified, because soft-tissue release alone will not suffice.