Vascular Preservation During Arthroscopic Osteoplasty of the Femoral Head-Neck Junction: A Cadaveric Investigation

Purpose: The goal of this study was to evaluate the risk of vascular injury with arthroscopic osteoplasty of the femoral head-neck junction in a cadaveric model. Methods: Eight fresh-frozen cadaveric pelvi were used for arthroscopic osteoplasty of a predetermined 150° arc of resection along the anterior femoral head-neck junction. Postoperatively, injection studies of the deep femoral arteries were performed on all specimens to identify local extravasation of neoprene latex before polymerization as a reproducible indicator of vascular injury. Control specimens included 1 specimen without an osteoplasty and 1 specimen after an “aggressive” open osteoplasty with intention to violate the superior retinacular vessels. Results: The first control specimen showed complete filling of the superior retinacula branches, whereas the second control specimen had evidence of intracapsular latex extravasation. In 7 of 8 experimental specimens, there was near-to-complete filling of the superior and inferior retinacula branches with no signs of latex extravasation. In 1 specimen, no superior retinacular branches were identified; however, no extravasation of the latex material was noted. No injury to the main extracapsular branches of the medial or lateral femoral circumflex vessels was noted. We noted on average 3 superior retinacular vessels penetrating the posterior-superior head-neck junction. Conclusions: There was no evidence of vascular injury to the main blood supply of the femoral head in any of the 8 experimental specimens as noted by latex extravasation. These findings show that arthroscopic osteoplasty can be performed without disrupting the vascular supply to the femoral head. Clinical Relevance: This article has important information on the relation of vascular structures and the resection limit with arthroscopic osteoplasty of the femoral head-neck junction.