The Femoral Head 'Divot' Sign: A Useful Arthroscopic Sign of Hip Microinstability
Authors
Rosinsky PJ, Mayo BC, Kyin C, Shapira J, Maldonado DR, Meghpara MB, Lall AC, Domb BG
DOI: 10.1177/2325967120917919
Background
A femoral head "divot" is a rare finding during hip arthroscopy, characterized by a linear chondral indentation. This study investigates the significance of this finding and its association with hip microinstability.
Methods
Intraoperative images from 690 hip arthroscopies were reviewed to identify cases with a femoral head divot. The study analyzed preoperative characteristics, physical exams, and radiographic findings to understand the relationship between this sign and hip instability.
Key Findings
The femoral head divot was found in 2% of cases, mostly in younger women. Patients with this sign often had ligamentous laxity and microinstability, and they also showed other signs of hip instability like labral tears and iliopsoas bursitis.
Conclusions
The femoral head divot is a useful arthroscopic sign of hip microinstability and may help guide treatment decisions, such as capsular plication to stabilize the hip.
What Does This Mean for Patients
If you’re undergoing hip arthroscopy, the presence of a femoral head divot might indicate hip instability, which can be addressed with additional surgical procedures like capsular repair to improve stability.