Feasibility and potential of intraoperative ultrasound in arthroscopy of femoroacetabular impingement

Abstract

ABSTRACT This study aimed to evaluate the feasibility of using ultrasound for monitoring osteochondroplasty intraoperatively, determine the factors that interfere with ultrasound imaging and assess its influence on surgeon performance. Intraoperative ultrasonography was performed during osteochondroplasty in 39 cases of arthroscopy. The femoral head–neck junction (FHNJ) was evaluated using ultrasonography. Another 39 cases, which underwent conventional arthroscopy, were included in the control group. The C-arm was used in this group at the end of osteochondroplasty to confirm that no residual cam lesion remained. Pre- and postoperative Dunn radiographs and computed tomography (CT) scans were analyzed to determine the feasibility of ultrasound. Residual cam deformity was noted in eight cases under ultrasound. The FHNJ was not detected owing to ultrasound interference by air in three cases. No difference in the α angle measured in Dunn radiographs and the residual cam deformity rate of CT at the 1:00, 2:00 or 3:00 position was found between both groups. However, the α angle at the 3:00 position was greater in the ultrasound group than in the control group (44.4 ± 4.3° versus 41.3 ± 5.1°, P < 0.05), suggesting that more bone was preserved at 3:00 in the ultrasound group. No difference was found in the mean operation time. None of the patients experienced complications, such as wounds or intra-articular infections. Ultrasound is a safe method for assessing FHNJ during arthroscopy. It did not change the risk of residual cam deformity but positively affected the surgeon’s performance by reducing unnecessary bone removal.