EP3.33 A Four-Scenario Postoperative Alpha-Angle Classification After Hip Arthroscopy for Cam-Type Femoroacetabular Impingement

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ID: 330931
2026
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Abstract
Abstract Background Postoperative alpha angle is widely used to assess the adequacy of cam correction after hip arthroscopy for femoroacetabular impingement syndrome (FAIS). However, a single numeric value may not fully describe the morphology of the femoral head-neck junction after osteochondroplasty. On the 45° Dunn view, different resection patterns may be observed despite similar postoperative alpha-angle values. A morphology-based classification may therefore provide additional information when interpreting postoperative cam correction. Purpose To describe a four-scenario postoperative alpha-angle classification on the 45° Dunn view after arthroscopic cam resection and to explore its association with patient-reported outcomes. Methods A retrospective cohort of 110 patients treated with hip arthroscopy for cam-type FAIS was analyzed. Postoperative alpha angles were measured on the 45° Dunn view. Each hip was assigned to one of four radiographic scenarios: anatomic correction with restoration of a round femoral head-neck contour; residual distal cam prominence despite an acceptable proximal transition; early-start over-resection with contour loss extending inside the reference circle; or delayed-start resection with persistent proximal cam morphology. Patient-reported outcomes were collected preoperatively, at 6 months, and at 12 months postoperatively, including the Hip and Groin Outcome Score (HAGOS), Non-Arthritic Hip Score (NAHS), modified Harris Hip Score (mHHS), hip pain, and quality-of-life measures. Longitudinal changes and between-group differences were evaluated to determine whether radiographic morphology corresponded to clinical recovery. Results The proposed classification allowed postoperative femoral morphology to be categorized into four reproducible radiographic patterns on the 45° Dunn view. Overall, patients demonstrated postoperative improvement in hip-specific function, pain, and quality-of-life measures. When outcomes were analyzed according to radiographic scenario, different recovery profiles were explored across groups, suggesting that morphology-based interpretation may add clinically relevant information beyond the numeric alpha angle alone. Conclusion This four-scenario postoperative alpha-angle classification provides a structured method to describe femoral head-neck morphology after arthroscopic cam resection. Used alongside quantitative alpha-angle measurement, it may improve radiographic interpretation and help clarify the relationship between postoperative resection morphology and clinical outcome after hip arthroscopy for cam-type FAIS. Keywords hip arthroscopy; femoroacetabular impingement syndrome; alpha angle; cam resection; radiographic classification.
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Authors Marco Pilone, Benedetta Dallari, Nicolas Bonin
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.318
URL
https://doi.org/10.1093/jhps/hnag043.318
Keywords Keywords not found

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