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Techniques in
Hip Arthroscopy and
Joint Preservation
Surgery
Techniques in
Hip Arthroscopy and
Joint Preservation
Surgery
With EXPERT
CONSULT Access
Jon K. Sekiya, MD Anil S. Ranawat, MD
Associate Professor and Team Physician Assistant Professor
MedSport Orthopaedic Surgery
Department of Orthopaedic Surgery Weill Medical College of Cornell University
University of Michigan
Ann Arbor, Michigan Assistant Attending
Orthopaedic Surgery
Hospital for Special Surgery
New York, New York

Marc R. Safran, MD Michael Leunig, MD

Professor and Associate Director PD Dr. Med.,
Sports Medicine Department of Orthopaedic Surgery
Department of Orthopaedic Surgery University of Bern
Stanford University Bern, Switzerland
Redwood City, California
Head of Orthopaedics
Department of Orthopaedics
Schulthess Clinic
Zürich, Switzerland
 1600 John F. Kennedy Blvd.
Ste. 1800
Philadelphia, PA 19103-2899

TECHNIQUES IN HIP ARTHROSCOPY AND ISBN: 978-1-4160-5642-3

JOINT PRESERVATION SURGERY
Copyright © 2011 by Saunders, an imprint of Elsevier Inc.

All rights reserved. No part of this publication may be reproduced or transmitted in any form or by
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Notice

Knowledge and best practice in this field are constantly changing. As new research and experience
broaden our knowledge, changes in practice, treatment and drug therapy may become necessary or
appropriate. Readers are advised to check the most current information provided (i) on procedures
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Library of Congress Cataloging-in-Publication Data

Techniques in hip arthroscopy and joint preservation surgery / [edited by] Jon K. Sekiya, Marc R. Safran,
Michael Leunig, Anil S. Ranawat. – 1st ed.
   p. ; cm.
Includes bibliographical references.
ISBN 978-1-4160-5642-3
1. Hip joint–Surgery. 2. Hip joint–Endoscopic surgery. I. Sekiya, Jon K. II. Safran, Marc R.
III. Leunig, Michael. IV. Ranawat, Anil S.
[DNLM: 1. Hip Injuries–surgery. 2. Arthroscopy–methods. 3. Hip Joint–surgery. WE 855 T255 2011]
RD772.T43 2011
617.5′81059–dc22
2009039236

Acquisitions Editor: Daniel Pepper

Developmental Editor: Julie Goolsby
Publishing Services Manager: Anitha Raj
Project Manager: Beula Christopher/Sara Alsup
Cover Designer: Ellen Zanolle

Printed in the United States of America

Last digit is the print number: 9 8 7 6 5 4 3 2 1

 Foreword to “Arthroscopic Management of Hip Diseases”

Today, surgeons routinely use the arthroscope for the diagno- After using the overhead traction device in a dozen patients we
sis and treatment of joint problems. However, few surgeons found that more distraction was needed to adequately ­examine the
apply the arthroscope to the hip joint. The reasons for the joint and to keep from damaging the joint surfaces. The distrac-
lack of interest in this procedure are because the deep posi- tion necessary to achieve this could not be obtained with over-
tion of the hip joint which makes it difficult to reach and there head traction. I then utilized a fracture table with the attachments
is small ­number of indications. In order for the surgeon to be adjusted for patients placed on their sides. Satisfactory ­distraction
adept at a difficult operation, he must perform the surgery fre- was achieved in every case with this device. However, there were
quently. Because of the lack of indications for hip arthroscopy, drawbacks, which included difficulty in rearranging the table for
it is almost ­impossible to perfect the technique. The surgeon the lateral approach, the inability to adjust the perineal post to
will often discard the procedure or refer it to someone who has prevent excessive pressure on the pudendal nerve, and the absence
experience in it. of a device to measure the amount of traction for safety reasons.
Unlike the knee, the hip joint is made up of two opposing In individuals with stiff joints, or in patients with hip contrac-
joint surfaces. It is a well-contained and stable joint, so it is tures, a large amount of traction might be necessary to adequately
protected from trauma. Therefore, many of the problems that distract the hip. In this situation a dangerous amount of pressure
occur in the hip joint are chronic and result in conditions that may be placed on the nerves of the limb and the perineum and if
are difficult to diagnose and treat. Although the arthroscope applied too long could cause paralysis.
is invasive, it has a low potential for complications and its low Once publications on the subject began to appear, a few
morbidity make it very useful for these chronic hip conditions. more surgeons began to perform the procedure and finally spe-
For instance, what is a better way to remove a symptomatic cific instruments and traction devices were developed, which
loose body from the hip than with the assistance of the arthro- made the procedure easier and safer. Drs. Thomas Byrd,iv
scope? The alternative method would involve a large incision Joseph McCarthy,v Henri Dorfmann,vi Eijner Eriksson,vii and
and ­dislocation of the hip. Richard Villarviii led this early charge and were instrumental in
I first performed hip arthroscopy in 1977 to evaluate a refining the procedure to the extent that made it more feasi-
­painful hip that had been nailed for a subtrochanteric fracture. ble. Instruments exclusive for the hip were developed. These
Roentgenograms and laboratory studies were normal. I sus- included longer arthroscopes and instruments that were essen-
pected that the problem was due to arthritis. At that time, I was tial to maintain the portals and reach the depths of the joint and
using the arthroscope in other joints mainly as a diagnostic curved instruments that helped in reaching the corners of the
tool, so why not the hip? Since there were no procedural pub- joint and made it possible to operate on the curved acetabulum.
lications on the subject at that time, I performed a ­technique Despite these advancements, the procedure only gained a little
that Dr. Lanny Johnsoni described to me. His method was first of the popularity that arthroscopy of the other joints had gained.
­published in [Link] The procedure was performed with the The reasons, at that time, appeared to be from a lack of indica-
patient supine on a fracture table. I visualized the hip through tions and to poor outcomes due to the association of degenera-
an anterior portal and arthritis was found. A hip replacement tion in so many of the cases. In the meantime, the few of us who
was carried out shortly thereafter. were performing the procedure gained more experience.
Between 1977 and 1984, I performed a total of ten cases In 2003, the work of Professor Reinhold Ganzix and his
using the supine position. On occasion, it was difficult to enter ­associates in Switzerland regarding hip impingement brought
the hip joint with this method, especially in obese individuals, new light on the cause of degeneration in the hip joint. His
because the instruments that were available were the same short
instruments that were used in the knee. Therefore, I felt that
a change was necessary. It all came about in the fall of 1983
when I was unsuccessful in the removal of loose bodies from a
i
Johnson LL: Personal Communication.
ii
Johnson LL: Diagnostic and Surgical Arthroscopy: The Knee and Other
hip in a heavy woman placed in the supine position. Following Joints, 2nd Ed. St. Louis: CV Mosby, 1981, pp. 405-411. 292-6804.
the case, my partner, Dr. Tom Sampson, and I discussed the iii
Glick JM, Sampson TG, Gordon RB, Behr JT, Schmidt E: Hip
­problem, and at his suggestion came to the conclusion that since Arthroscopy by the Lateral Approach. Arthroscopy 1987; 3: 4-12.
the lateral approach permits the fat to drop downward, away iv
Byrd JWT: Hip Arthroscopy Utilizing the Supine Position.
from the operative sight, better access to the hip joint would be Arthroscopy. 1994; 10: 275-280.
achieved. We started by supporting the patient’s leg in a wrap v
McCarthy JC, Day B, Busconi B: Hip Arthroscopy: Applications and
around the calf, which was connected to overhead weights by a Technique. J Am Acad Orthop Surg. 1995; 3: 115-122.
rope placed through pulleys hung from the ceiling. After per-
vi
Dorfmann H, Boyer T, Henry P, de Bie B: A Simple Approach to Hip
forming the procedure successfully in several patients placed on Arthroscopy. Arthroscopy. 1988; 4: 141-142.
vii
Eriksson E, Arvidsson I, Arvidsson H. Diagnostic and Operative
their sides, including a 5 ft. 5 in. tall, 270 lb person, I ­contacted Arthroscopy of the Hip. Orthopedics. 1986; 9: 169-176.
the woman who had loose bodies that I earlier failed to remove viii
Villar RN: Hip Arthroscopy. Oxford: Butterworth-Heinemann, 1992.
using the supine approach and scheduled her for another ix
Ganz R, Parvizi J, Beck M, Leunig M, Nötzli H, Siebenrock K:
­surgery in which I now successfully extracted five loose bodies Femoroacetabular Impingement: A Cause for Osteoarthritis of the Hip:
by the lateral [Link] Clinical Orthop. 2003; 417: 112-120.

xi
xii Foreword TO “ARTHROSCOPIC MANAGEMENT OF HIP DISEASES”

procedure to correct this was found to be adaptable to arthros- fact that it uses minimal incisions and reduces morbidity, but
copy. The hip surgeons took notice and found arthroscopy to be also is designed to preserve the joint as much as possible. This
­beneficial in their practice and started to perform the procedure, book is valuable in that it combines both arthroscopy and the
greatly increasing the numbers that used it. As more arthroscopies more established open techniques in the diagnosis and treat-
were carried out, more refinements were made, more information ment of these hip conditions. It is not easy for surgeons to grasp
about the anatomy of the hip was attained, and the outcomes of the the challenge of arthroscopy of the hip when it was hardly used
procedure improved. This brings us to today where hip arthros- just a decade or so ago. This text, with its combination of open
copy has become an integral part of the diagnosis and treatment of and arthroscopic methods, should certainly expand surgeons’
hip diseases. More advances will come in the future. Already there knowledge and give them more alternatives in the treatment of
have been trials of the use of polymers for resurfacing knee joints some of the most difficult conditions of the hip joint. It should
in patients and hip joints in cadaver specimens. also spark interest for traditional surgeons to attempt this pro-
The hip is the largest joint in the body and is the site of major cedure. Furthermore, the section on arthroscopy will help sur-
diseases in patients of all ages from childhood to the elderly. geons in their endeavor to learn the principles of arthroscopy
Therefore, it is imperative for the surgeons who treat the hip to as they relate to the more conventional open procedures and to
know all the treatment options available including arthroscopy. hone the arthroscopic skills necessary to diagnose and treat the
The significant features of arthroscopic surgery are not only the various hip diseases that they will encounter.
James M. Glick, M.D.
 Foreword to “Open Management in Joint Preservation Surgery”

The timing of this textbook consisting of chapters on the diag- of hip replacement with synthetic materials. These materials
nosis and nonprosthetic surgical management of difficult yet were studied to understand their behavior under conditions of
common problems of the hip is propitious. Conservative man- motion and load.
agement of hip arthosis, usually through dropping the pressure Indeed, study of factors producing accelerated wear in arti-
in the joint, was widely written about in the seventies and early ficial hip joints or causes of their frequent dislocations identi-
eighties has not been updated with a dedicated volume in the fied the phenomenon of motion-induced impingement caused
last fifteen years. by mechanical conflict between the components of the hip joint
This is true, despite significant new observations about the replacement. This observation led to design modifications of
etiology of hip arthrosis, new high-tech imaging techniques, new both femoral and acetabular components to avoid this occur-
surgical approaches, and new procedures which have evolved rence. Understanding of this problem in the setting of total
to improve the outcome of treatment in this special group of hip arthroplasty strongly suggested the possibility of the exis-
patients. tence of this problem in the natural hip and in hips treated with
The majority of these patients suffer from irritable hips and osteotomy.
early arthosis. Most have deformities and morphological abnor- Indeed in the relatively small group of patients with dys-
malities that are secondary to congenital or acquired distur- plastic hips who had pain following periacetabular osteotomy,
bances of normal hip development. physical findings on examination, and radiographic evidence
Most of the innovations in diagnosis and treatment can be identified impingement between the femur and the acetabu-
directly attributed to those that studied with or were influ- lum as the cause of these residual symptoms. Many had classical
enced by the orthopedic department at the University of Bern, findings of impingement on the femoral head and characteristic
Switzerland. The chairman of the department during this time, acetabular labral damage at the time of re-operation.
Reinhold Ganz, was a master surgeon and successor to world- The paramount contribution that expanded the understand-
famous hip surgeon Professor Maurice Mueller. ing of the pathological findings of hip impingement came with
Bern, always an active academic center, provided a fer- the study of the anatomical course of the medial femoral cir-
tile environment for further refinement of “the conservative cumflex vessels. This doctoral thesis, by Katharina Ganz and
approaches” to the problems of the young adult with painful Nathalie Kruegel, offered objective evidence that it was possible
hip joints. to dislocate the human hip joint without the complication of
In 1984, Professor Ganz with the collaboration of his team, avascular necrosis.
focused on the problem of the residuals of hip dysplasia and This finding opened the door to surgical exploration of
developed a new “Periactabular Osteotomy” that allowed unre- symptomatic hips in patients with what had been thought previ-
stricted correction of the associated deformities. In addition, ously to be negative x-ray images. Quite rapidly the concepts of
the procedure could be carried out through a single exposure. “cam” and “pincer” impingement became accepted as the cause
Although there are many different surgical procedures for of symptoms in these hips and the subtle radiographic and MRI
the correction of dysplastic hips, “the Bernese” periacetabular findings were defined.
osteotomy became a popular and well-accepted procedure for Finally, the interest in joint-preserving surgery continued at
the treatment of hip dysplasia in the patient with closed phy- the Inselspital in Bern, but with a major difference. The goal of
seal plates. surgery was no longer to increase congruency and the relative
The long-term follow up of the patients who had undergone area of the articular surface, but rather the elimination of the
PAOs actually contributed to the identification of femoroac- conflict between the femur and acetabulum during the func-
etabular impingement, the next major discovery in Bern during tional motion of the joint.
the Ganz tenure. This book is a much awaited reference on the details of these
In Orthopedic Surgery, the sixties and seventies were domi- new concepts, including the very important subject of the role
nated by teaching and studying outcomes of total hip arthro- of arthroscopy in the management of these difficult cases.
plasty. There was change in the focus of a majority of orthopedic
Jeffrey W. Mast, M.D.
surgeons from classical operations such as osteotomies, as pos-
Reno, Nevada
tulated by Pauwels and his students, to the complicated subject
August, 2009

xiii
 Acknowledgments

I would like to thank the many people who have helped me of trying to collaborate and cooperate to solve the problems of
develop into a hip arthroscopist from the very beginning in understanding the non-arthritic hip. I think all hip arthrosco-
medical school, where my interest was first sparked by Evan pists owe a debt of gratitude for the foresight of Jim Glick as
Ekman, Dave Ruch, and Gary Poehling. Ed Wojtys furthered well as Reinhold Ganz for his contributions to the understand-
this interest in hip arthroscopy in my residency and has been ing of the pathophysiology of the non-arthritic hip.
a mentor to me since in all aspects of my career. Ron Delanois And lastly, but most importantly, I want to thank my
helped me when I was just starting out in the Navy with my wonderful, saintly wife, Lee, for her unwavering support and
first hip scopes teaching me his tricks. Freddie Fu gave me the her sacrifices to allow me to chase my professional dreams. And
opportunity to come back to Pittsburgh and join his outstand- for my children, Janna, Nathan, and Clark, who have always
ing group (my fellowship alma mater!) and develop a really supported me, no matter how late I come home or how many
busy hip arthroscopy practice. And of course Marc Philippon weekends I spend on these pursuits, with their unconditional
who was gracious enough to let me come to Vail and scrub love—thank you for your support and love. I love you with all
with him and really teach me the art of hip arthroscopy of my heart.
which he has been such a tremendous pioneer in developing
Marc R. Safran
many of these techniques and really pushing our field for-
ward. I would like to thank my co-editors, Marc Safran, who
has also been a real mentor to me in the hip surgery realm and
I would like to thank my mentors who have shaped my young
in many other aspects of my career, and he is a good friend
surgical career and who have all been instrumental in unique
as well; and Michael Leunig, who lends such tremendous
ways in helping me with this book. I have been exposed to
expertise to this book with his pioneering work in femoro-
and trained by true giants in orthopedics. At my residency at
acetabular impingement and so much other groundbreak-
the Hospital for Special Surgery, Drs. Russell Warren, Tom
ing hip research; and Anil Ranawat, who has done a lion’s
Wickiewicz and David Altchek first exposed me to arthros-
share of work toward getting this book completed and with-
copy and Sports Medicine. I first learned open hip surgery
out his tremendous effort and his insight, ability, and energy,
from Drs. Thomas Sculco, Paul Pellicci, Eduardo Salvati, and
this book never would have been completed. I also want to
David Helfet. During my Sports fellowship at the University
thank the love of my life, my best friend, and ever supportive
of Pittsburgh, Drs. Freddie Fu and Christopher Harner fur-
wife, Jennie: thanks for everything. And to my sons, 3-year-
thered my interest in joint preservation, arthroscopy, and Sports
old Kimo and 1-year-old Koa, I love you guys more than you
Medicine. It was there that I first met Jon Sekiya, who has been
know.
a great source of inspiration, teaching, and support for this book
Jon K. Sekiya as a co-editor. After Pittsburgh, Dr. Robert L. Buly encouraged
me to apply to the prestigious Maurice Mueller Hip Fellowship
in Switzerland. My experience in Zurich and Bern was inspir-
I would like to thank Jon Sekiya and Anil Ranawat for bring- ing. It was here where I was introduced to Dr. Michael Leunig
ing me in to their vision (and doing the bulk of the work), and Professor Reinhold Ganz. Michael Leunig has provided
and to Michael Leunig for bringing his knowledge, experi- guidance, friendship, and tremendous support of this book and
ence, and expertise to help round out this wonderful work. I my career. After Switzerland, I traveled to the United Kingdom,
am very thankful for and appreciate the friendship, expertise, where I met Mr. Derek McMinn and Mr. Richard Villar. When
professionalism, and efforts of my co-editors. I would also like I returned to HSS, my friends and mentors have been Drs. Dean
to thank the many authors who contributed their knowledge Lorich and Bryan Kelly, who have both supported, guided, and
and expertise to this compilation that I hope will serve as a ref- trained me throughout my entire career. There have been other
erence and guide for many surgeons, experienced and novice, notables like my co-editor, Marc Safran, who has been extremely
around the world as we embark on this new era of understand- supportive throughout this entire process as well as Larry Dorr,
ing and treating the non-arthritic hip. I also thank our develop- who has been a family friend for many years.
ment editors who have allowed us to put together a book that Lastly, I would like to thank my family. My oldest brother,
is first class. Amar Ranawat, has been a friend, mentor, and a great curbside
I am particularly indebted to my many mentors for their help consult, even if he is a total joint surgeon. Most importantly,
in my education as a clinician, surgeon, and researcher and the I thank the greatest anatomist, scientist, friend, and surgical
many sports medicine experts who have taken me under their mentor anyone could have, my father, Dr. C.S. Ranawat. My
wing over the years and helped guide me in my early years of father never pushed me to be an orthopedist but rather pro-
hip arthroscopy. I am also very appreciative of my friends and vided lessons for success in life. His “Ranawat Rules” govern
colleagues in the MAHORN group who have shared the vision my approach to my own family as well as my work life. He has

xv
xvi Acknowledgments

always supported me, even my interest in this field, which at The continuous questioning of the pre existing dogma con-
times he questioned. Thank you, Dad. I love you and you have cerning primary osteoarthritis has led to the novel concept
no idea how much I respect you. Last but not least, I have to of femoroacetabular impingement and its role in native hip
thank my wife, Dana, whose support and love have been unwav- osteoarthritis. All of us are indebted to Professor Reinhold
ering, as well as my son, Cooper, and my little one on the way. I Ganz for his contributions to our current comprehension of hip
love you guys and this book is for you. anatomy, pathology, and joint-preserving surgery.
Anil S. Ranawat Michael Leunig
   List of Contributors xvii

List of Contributors

J. Mack Aldridge, III, MD Karen K. Briggs, MPH

Fellowship Director Director of Clinical Research
Triangle Research Associates, P.A. Steadman Philippon Research Institute
Orthopaedic Surgery Vail, Colorado
Durham, North Carolina
Robert L. Buly, MD
Champ L. Baker III, MD Associate Professor
Fellow Orthopaedic Surgery
Division of Sports Medicine Weill Cornell Medical College
Department of Orthopaedic Surgery
Rush University Medical Center Associate Attending
Chicago, Illinois Orthopaedic Surgery
Hospital for Special Surgery
Champ L. Baker, Jr., MD New York, New York
Clinical Assistant Professor
Department of Orthopaedics Denise Chan, BSc, MBT
Medical College of Georgia Orthopaedic Research Coordinator
Augusta, Georgia Sport Medicine Centre
University of Calgary
Staff Physician Calgary, Alberta, Canada
The Hughston Clinic
Columbus, Georgia Lorenzo Childress, MD
Rubin Institute for Advanced Orthopedics
Nikolaos V. Bardakos, MD Center for Joint Preservation and Replacement
Consultant Orthopaedic Surgeon Sinai Hospital of Baltimore
The South West London Elective Orthopaedic Center Baltimore, Maryland
Epsom, Surrey, UK
John C. Clohisy, MD
Paul E. Beaulé, MD, FRCSC Professor, Orthopaedic Surgery
Associate Professor Co-Chief, Adult Reconstructive Surgery
Surgery, University of Ottawa Director, Adolescent and Young Adult Hip Service
Department of Orthopaedic Surgery
Head Washington University School of Medicine
Adult Reconstruction Orthopaedics St. Louis, Missouri
The Ottawa Hospital
Ottawa, Ontario, Canada Ronald E. Delanois, MD
Fellowship Director
Martin Beck, MD, PD Rubin Institute for Advanced Orthopedics
Head Center for Joint Preservation and Replacement
Clinic for Orthopaedic Surgery Sinai Hospital of Baltimore
Luzerner Kantonsspital Baltimore, Maryland
Luzern, Switzerland
Octavia Devon, MD
Michel P. J. v/d Bekerom, MD Resident
Department of Orthopaedic Surgery Urology, University of Florida
Academic Medical Center
Amsterdam, The Netherlands Shands at the University of Florida
Urology, University of Florida
Benoit Benoit, MD, FRCS
Division of Orthopaedics Malcolm Randall VA Medical Center
Ottawa Hospital General Campus Urology
Ottawa, Ontario, Canada Gainesville, Florida

xvii
xviii List of Contributors

Michael Dienst, MD Jon A. Jacobson, MD

OCM Orthopaedic Surgery Munich Professor
Munich, Germany Department of Radiology
University of Michigan
Keelan R. Enseki, MS, PT, ATC, OCS, SCS, CSCS
Adjunct Instructor Director
Physical Therapy Division of Musculoskeletal Radiology
Sports Medicine and Nutrition Department of Radiology
University of Pittsburgh University of Michigan
Pittsburgh, Pennsylvania Ann Arbor, Michigan

Teresa M. Ferguson, MD David Kahan

Department of Orthopaedic Surgery Department of Surgery
University of Iowa Hospitals and Clinics Drexel University College of Medicine
Iowa City, Iowa Philadelphia, Pennsylvania

Reinhold Ganz, MD Bryan T. Kelly, MD

Professor and Chairman Emeritus Assistant Professor
Department of Orthopaedic Surgery Orthopaedic Surgery
University of Bern Weill Cornell Medical College
Bern, Switzerland
Assistant Attending
Orthopaedic Surgery
Michael B. Gerhardt, MD Co-Director, Center for Hip Pain and Preservation
Director, Center for Athletic Hip and Groin Disorders Hospital for Special Surgery
Santa Monica Orthopaedic and Sports Medicine Group New York, New York
Team Physician, CD Chiva USA
Team Physician, US Soccer
Santa Monica, California Vikas Khanduja, MRCS(G), MSc, FRCS(Tr and Orth)
Consultant Orthopaedic Surgeon
Department of Trauma and Orthopaedics
James A. Goulet, MD Addenbrooke’s—Cambridge University
Professor Hospitals NHS Trust
Department of Orthopaedic Surgery
University of Michigan Medical School Consultant Orthopaedic Surgeon
Department of Trauma and Orthopaedics
Director Cambridge Nuffield Hospital
Division of Orthopaedic Trauma Cambridge, UK
Department of Orthopaedic Surgery
University of Michigan Hospitals
Ann Arbor, Michigan Mininder S. Kocher, MD, MPH
Associate Professor
Department of Orthopaedic Surgery
Carlos A. Guanche, MD Harvard Medical School
Southern California Orthopedic Institute
Van Nuys, California Associate Director
Division of Sports Medicine
Daniël Haverkamp, MD, PhD Children’s Hospital Boston
Academic Medical Center
University of Amsterdam Department of Orthopaedic Surgery
Department of Orthopaedic Surgery Children’s Hospital Boston
Amsterdam, The Netherlands Boston, Massachusetts

Marcia A. Horner, BA Jason Koh, MD

Office Manager for William C. Meyers, MD Clinical Associate Professor
Department of Surgery Surgery, University of Chicago
Drexel University College of Medicine Pritzker School of Medicine
Philadelphia, Pennsylvania Chicago, Illinois

Victor M. Ilizaliturri, Jr., MD Vice-Chairman

Professor of Hip and Knee Surgery Orthopaedic Surgery
Universidad Nacional Autónoma de México NorthShore University HealthSystem
National Rehabilitation Institute of Mexico Evanston, Illinois

Chief
Adult Hip and Knee Reconstruction
National Rehabilitation Institute of Mexico
Mexico City, Mexico
   List of Contributors xix

David A. Kuppersmith, BS Aditya V. Maheshwari, MD

Clinical Research Clinical Fellow
Steadman Philippon Research Institute Ranawat Orthopaedic Center
Vail, Colorado Hospital for Special Surgery
New York, New York
Christopher M. Larson, MD
Director of Education David R. Marker, BS
Minnesota Sports Medicine Fellowship Program Rubin Institute for Advanced Orthopedics
Minnesota Sports Medicine Center for Joint Preservation and Replacement
Twin Cities Orthopedics Sinai Hospital of Baltimore
Eden Prairie, Minnesota Baltimore, Maryland

Jo-Ann Lee, MS René K. Marti, MD, PhD

Nurse Practitioner Professor Emeritus
Research Assistant, Orthopaedics Orthopedics, University of Amsterdam
Massachusetts General Hospital
Boston, Massachusetts Professor Dr.
Orthopedic Department
Michael Leunig, MD Academical Medical Center
PD Dr. Med., Amsterdam, The Netherlands
Department of Orthopaedic Surgery
University of Bern Prof. Dr. Med.
Bern, Switzerland Klinik Gut
St. Moritz, Switzerland
Head of Orthopaedics
Department of Orthopaedics Hal David Martin, DO
Schulthess Clinic Doctor of Osteopathy
Zürich, Switzerland Sports Medicine/Hip Disorders
Oklahoma Sports Science and Orthopaedics
Kartik Logishetty, MD
Guy’s, King’s and St. Thomas’ Medical School Northwest Surgical Hospital
King’s College London Oklahoma City, Oklahoma
London, UK
RobRoy L. Martin, PhD, PT, CSCS
Dean G. Lorich, MD Associate Professor
Associate Professor Physical Therapy, Duquesne University
Orthopaedic Surgery Pittsburgh, Pennsylvania
Weill Cornell Medical College
Staff Physical Therapist
Associate Director Centers for Rehab Services/Center for Sports Medicine
Orthopaedic Trauma Service University of Pittsburgh Medical Center
Hospital for Special Surgery Pittsburgh, Pennsylvania
New York, New York
Joseph C. McCarthy, MD
Travis Maak, MD Clinical Associate in Orthopaedic Surgery
Chief Resident Department of Arthroplasty
Orthopaedic Surgery Harvard University
Hospital for Special Surgery Cambridge, Massachusetts
New York, New York
Vice Chairman
Orthopaedic Surgery
Tallal Charles Mamisch, MD Department of Orthopaedics
Research Instructor
Massachusetts General Hospital
Clinical Research
Boston, Massachusetts
MR Methodology and Spectroscopy Unit
Director
Research Instructor
Center for Joint Reconstructive Surgery
Orthopaedic Surgery
Department of Orthopaedics
Inselspital, University of Bern
Newton-Wellesley Hospital
Bern, Switzerland
Newton, Massachusetts
Visiting Research Instructor
Orthopaedic Surgery Mike S. McGrath, MD
Children’s Hospital, Harvard Medical School Rubin Institute for Advanced Orthopedics
Boston, Massachusetts Center for Joint Preservation and Replacement
Sinai Hospital of Baltimore
Baltimore, Maryland
xx List of Contributors

Morteza Meftah, MD Mario Quesada, MD

Orthopaedic Fellow Rubin Institute for Advanced Orthopedics
Ranawat Orthopaedic Center Center for Joint Preservation and Replacement
Hospital for Special Surgery Sinai Hospital of Baltimore
New York, New York Baltimore, Maryland

William C. Meyers, MD Amar S. Ranawat, MD

Chairman Assistant Professor of Orthopaedic Surgery
Department of Surgery Weill Cornell Medical College
Drexel University College of Medicine Hospital for Special Surgery
Philadelphia, Pennsylvania New York, New York

Nick G. Mohtadi, MD, MSc, FRCSC Anil S. Ranawat, MD

Clinical Professor Assistant Professor
Sports Medicine Centre Orthopaedic Surgery
University of Calgary Weill Medical College of Cornell University
Calgary, Alberta, Canada
Assistant Attending
Orthopaedic Surgery
Michael A. Mont, MD Hospital for Special Surgery
Director
New York, New York
Rubin Institute for Advanced Orthopedics
Center for Joint Preservation and Replacement
Sinai Hospital of Baltimore Chitranjan S. Ranawat, MD
Baltimore, Maryland Professor of Orthopaedic Surgery
Hospital for Special Surgery
New York, New York
Ryan M. Nunley, MD
Assistant Professor
Department of Orthopaedic Surgery
Margaret M. Rich, MD, PhD
Assistant Chief of Staff
Washington University
Pediatric Orthopaedics
St. Louis, Missouri
Shriners Hospitals for Children
St. Louis, Missouri
M. Elizabeth Pedersen, MD
Orthopaedic Resident, R5 Hassan Sadri, MD
Sport Medicine Centre Consultant Orthopaedic Surgeon
University of Calgary Clinic of Orthopaedic Surgery
Calgary, Alberta, Canada Geneva University Hospital
Geneva, Switzerland
Murat Pekmezci, MD
Assistant Clinical Professor Head
Orthopaedic Surgery Department of Orthopaedic Surgery
University of California Hospital of Fribourg—Riaz
San Francisco, California Riaz, Fribourg, Switzerland

Aaron Perdue, MD Marc R. Safran, MD

Assistant Professor Professor and Associate Director
Department of Orthopaedic Surgery Sports Medicine
Vanderbilt University Department of Orthopaedic Surgery
Nashville, Tennessee Stanford University
Redwood City, California
Marc J. Philippon, MD Thomas G. Sampson, MD
Associate Clinical Professor Director of Hip Arthroscopy
Department of Surgery Post Street Surgery Center
Faculty of Health Sciences
McMaster University Medical Director
Hamilton, Ontario, Canada Total Joint Center
Saint Francis Memorial Hospital
Managing Partner, Orthopaedic Surgeon
San Francisco, California
The Steadman Clinic

Steadman Philippon Research Institute Perry L. Schoenecker, MD

Vail, Colorado Professor
Orthopaedic Surgery
Washington University School of Medicine
   List of Contributors xxi

Interm Chair Zackary D. Vaughn, MD

Pediatric Orthopaedics Fellow
St. Louis Children’s Hospital Orthopaedic Sports Medicine
Stanford University
Chief of Staff Redwood City, California
Shriners Hospital for Children
St. Louis, Missouri Richard N. Villar, BSc, MA, MS, FRCS
Consultant Orthopaedic Surgeon
Karl F. Schultz, MD The Richard Villar Practice
Clinical Instructor The Wellington Hospital
Orthopaedic Surgery London, UK
University of Michigan
James E. Voos, MD
Attending Physician Fellow
Orthopaedics, Veterans Hospital of Ann Arbor Orthopaedic Surgery
Ann Arbor, Michigan Hospital for Special Surgery
New York, New York
Jon K. Sekiya, MD
Associate Professor and Team Physician
MedSport
Stuart L. Weinstein, MD
Ignacio V. Ponseti Chair and Professor of Orthopaedic
Department of Orthopaedic Surgery
Surgery
University of Michigan
Department of Orthopaedic Surgery
Ann Arbor, Michigan University of Iowa
Iowa City, Iowa
Michael K. Shindle, MD
Fellow Stefan Werlen, Dr. Med., MD
Orthopaedic Surgery Head
Hospital for Special Surgery Department of Radiology
New York, New York Klinik Sonnenhof
Bern, Switzerland
Klaus A. Siebenrock, MD
Professor and Chairman Yi-Meng Yen, MD, PhD
Department of Orthopaedic Surgery Clinical Instructor
Inselspital, University of Bern Orthopaedics, Harvard Medical School,
Bern, Switzerland Children’s Hospital Boston
Boston, Massachusetts
Moritz Tannast, MD
Department of Orthopaedic Surgery Chad T. Zehms, MD
Inselspital, University of Bern Staff Orthopaedic Surgeon
Bern, Switzerland Orthopaedic Surgery
Naval Hospital Great Lakes
Mehul M. Taylor, MD Great Lakes, Illinois
Fellow
Minnesota Sports Medicine Fellowship Program Staff Orthopaedic Surgeon
Minnesota Sports Medicine Orthopaedic Surgery
Twin Cities Orthopedics Prevea Health
Eden Prairie, Minnesota Green Bay, Wisconsin

James R. Urbaniak, MD
Virginia Flowers Baker Professor of
Orthopaedic Surgery
Orthopaedic Surgery
Duke University Medical Center
Durham, North Carolina
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