Femoral Head Pathology

Mark G. Bowditch and Richard N. Villar

Pathological conditions of the femoral head constitute approximately one-third of disorders diagnosed at hip arthroscopy.1 Because clear preoperative diagnoses are uncommon, many of the those with undiagnosed hip pain undergoing arthroscopy are subsequently found to have femoral head pathology. A recent study1 reports that 45% of those with "idiopathic hip pain" have femoral head pathology. The purpose of this chapter is to describe in detail the arthroscopic appearance, management, and outcome of pathological conditions affecting the femoral head. The senior author's (RNV) experience of hip arthroscopy extends to nearly one thousand cases. Thirty-four percent of these had a defined lesion of the femoral head.

In order to help orientation and understanding of the subsequent descriptions, with particular reference to arthroscopic surgery of the femoral head, the senior author's technique for hip arthroscopy is briefly outlined. A more detailed description of the author's technique is available in the literature.2

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