Closed Intramedullary Derotational Osteotomy and Hip Arthroscopy for Cam Femoroacetabular Impingement From Femoral Retroversion Dean K. Matsuda, M.D.,

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Closed Intramedullary Derotational Osteotomy and Hip Arthroscopy for Cam Femoroacetabular Impingement From Femoral Retroversion Dean K. Matsuda, M.D., Nikhil Gupta, B.A., Hal D. Martin, D.O. Arthroscopy Techniques Volume 3, Issue 1, Pages e83-e88 (February 2014) DOI: 10.1016/j.eats.2013.08.013 Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 1 Preoperative magnetic resonance image showing femoral retroversion of both lower extremities. Distal femoral transepiphyseal axis and femoral neck axis of left (black arrows) and right (grey arrows) lower extremities. Arthroscopy Techniques 2014 3, e83-e88DOI: (10.1016/j.eats.2013.08.013) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 2 Pre-osteotomy supine arthroscopic image of left hip, as viewed from anterolateral portal, showing sufficient previous femoroplasty (asterisk). The red line depicts sufficient anterior offset. (FH, femoral head.) Arthroscopy Techniques 2014 3, e83-e88DOI: (10.1016/j.eats.2013.08.013) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 3 Intraoperative fluoroscopic image after insertion of intramedullary saw to level of desired osteotomy. One should note that the saw blade is protected behind the distal cam (red arrow), enabling insertion and removal from the femoral intramedullary canal. The area of previous arthroscopic femoroplasty (blue arrow) should also be noted. Arthroscopy Techniques 2014 3, e83-e88DOI: (10.1016/j.eats.2013.08.013) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 4 Intraoperative fluoroscopic image showing intramedullary transverse osteotomy at subtrochanteric level of left femur. One should note the deployed saw blade from “under” the protective metallic cam (arrow). Arthroscopy Techniques 2014 3, e83-e88DOI: (10.1016/j.eats.2013.08.013) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 5 Postoperative anteroposterior radiograph of right femur showing healed derotational osteotomy. Arthroscopy Techniques 2014 3, e83-e88DOI: (10.1016/j.eats.2013.08.013) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 6 Postoperative anteroposterior radiograph of left femur showing healed derotational osteotomy. Arthroscopy Techniques 2014 3, e83-e88DOI: (10.1016/j.eats.2013.08.013) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions