Femoralplasty Cam Impengment

Femoroplasty (Cam Impingement)

Femoralplasty Cam Impengment

Injury Overview 

Femeroacetabular Impingment, often referred to as FAI for short, refers to a condition where there is a abnormality of the shape of the bones of the hip joint. FAI can include an abnormality of the femur, bone in the thigh, where it is shaped like a ball (Femoral Head), or FAI can include an abnormality of the pelvic bone where it is shaped like a socket (Acetabulum). A Cam lesion is an abnormality in the shape of the femur where it changes in shape from a tubular structure to a ball. The transition section of the femur is known as the femoral neck. A Cam lesion is a bump at the junction of the femoral neck and femoral head. With certain hip motions, impingement can occur due to Cam lesions. Over time, this abnormal fit/interaction may result in injury to the acetabular labrum and articular cartilage within the hip joint. Cam impingment can occur in athletes whose sport involves significant rotational motion of the hip, including cyclists, golfers, ballet dancers, and football players. Surgical reshaping the femoral head and neck junction is known as femeroplasty and often involves an arthroscopic burr.

Initial treatment measures for Cam impingement are non-operative and will include rest, activity modification, and physical therapy to strengthen the core musculature area, as well as the muscles around the hip. If a patient continues to have ongoing hip pain, then surgery is usually recommended to correct the bony conflict and address any labral or cartilage problems.

Dr. Anz will use an arthroscopic surgical approach that will consist of keyhole incisions that are made in the skin, which allow a small camera and surgical tools access to the joint. During arthroscopic femoroplasty surgery for the treatment of Cam impingement, the Cam lesion (the bony abnormality) will be removed using an arthroscopic burr. The section of the femur at the head and neck junction is reshaped, creating a smooth transition which eliminates impingment. During this same procedure, Dr Anz will address the labrum and articular cartilage if it is found that damage has occurred to these structures.

Following surgery, physical therapy is very important. A therapy regimen will be prescribed which will work on regaining motion of the hip while protecting repairs. Patients will be required to use crutches for typically 4 weeks and a brace to protect the hip during healing. Physical therapy will be a progressive process incorporating range of motion movements and strengthening exercises.

For more information on FAI impingement of the hip, Cam impingement, or for additional resources on hip impingement treatments including arthroscopic femoroplasty, please contact the Gulf Breeze, Florida orthopedic surgeon, Dr. Adam Anz located at the Andrews Institute.

Running Exercise

Hip Instability

Running Exercise

In orthopedics, instability occurs when patients have pain or discomfort due to abnormal looseness of a joint.   When a joint completely comes out of place it is called a dislocation.  When a joint partially comes out of place it is called subluxation.  In almost all cases involving the hip, it takes a great force or special scenario to dislocate, such as a motor vehicle accident.  Hip subluxations may require less force such as in the setting of football or soccer injuries.  With these types of injury, normal stabilizing structures may be compromised, for example ligaments that normally hold the joint securely in place may become stretched or torn. Hip instability may result and in this scenario it is known as traumatic hip instability.  A second type of hip instability is called acquired hip instability.  This type arises from recurrent microtrauma to normal stabilizing structures.  This can occur through normal activities in patients with abnormal anatomy such as in the setting of femoroacetabular impingment or hip dysplasia, or it may also occur in patients who perform certain repetitive activities which involve repetitive extreme movements which may slowly stretch the joint capsule with time.

Symptoms

Hip instability may cause one or more of the following symptoms:

  • •          Pain or the feeling that the hip will dislocate with certain movements
  • •          Deep aching in the hip joint
  • •          A repetitive clicking with certain activities or movements

Diagnosis

Dr. Anz will begin with a detailed discussion regarding previous injuries, surgeries, or activities that may include repetitive motions.  He will then perform a thorough exam of the hip joint and will assess the stability by performing specific movements and a series of stability tests. X-rays will be obtained to evaluate the joint space at the hip and check for underlying bony abnormalities.  If a patient has dislocated or subluxed his/her hip, it is often important to obtain a more in-depth study such as an MRI scan or a CT scan.

Treatment

Non-surgical treatment is almost always the best first step. After an initial traumatic event, a period of rest  to allow the capsule and/or surrounding soft tissue to heal is followed by a period of strengthening with physical therapy.  In patients with acquired instability, activity modification, strengthening methods with physical therapy focusing on pelvic girdle strengthening, and anti-inflammatory medications are the initial treatments. These treatments seek to reduce hip irritation and improve dynamic stabilization (stabilization provided by muscles) for the hip joint.  If these non-surgical treatments are not successful and symptoms continue, Dr. Anz may discuss surgery as an option.

Surgical Treatment

If surgery is necessary, Dr. Anz prefers an arthroscopic approach to treat hip instability.  Arthroscopic hip surgery uses several keyhole incisions, a tiny camera, and special instruments to allow Dr. Anz a complete view of the inside of the hip joint. The exact type of surgery will depend on the condition and/or the nature of the injury. Thus, each surgical treatment will vary from patient to patient. In some cases, Dr. Anz will tighten the hip capsule (inner lining of the hip joint).  The acetabular labrum is a structure important for hip stability. If it has been injured, it sometimes requires repair.  These procedures may occur in isolation, or together, in order to stabilize the hip and improve/maintain hip motion.

joint xray

Post-Operative

Dr. Anz will prescribe a progressive, thorough physical therapy program following arthroscopic surgery.  Working diligently with a therapist after a hip surgery is important to regain motion, strength, and function.  Dr. Anz and his staff will outline a customized therapy regimen to guide patients toward the best recovery possible after their surgery.

If you have any questions relating to hip instability or any other hip related injuries, please contact the Gulf Breeze, Florida orthopedic surgeon, Dr. Adam Anz located at the Andrews Institute. 

Stem Cells

Dr. Anz and Dr. Saw’s Publication Highlighted by Arthroscopy Journal

Stem Cells

The results of Dr. Saw’s recent clinical trial involving peripheral blood stem cells was published in this month’s Arthroscopy Issue. 

Dr. Anz and Dr. Jee among other authors helped to collect, synthesize, and statistically asses the data for this publication.   The results from this trial are a critical step forward in bringing this new technique to patients all over the world.  Further preparations are being made by the team to present information to the FDA to allow trials involving this technique.  The goal is to begin a clinical trial in the United States in January of 2014.

To read the full article, please, click here.

Chicago Dr. Adam Anz.

Dr. Anz Presents at the American Academy of Orthopaedic Surgeons Annual Meeting in Chicago

Chicago Dr. Adam Anz.

Dr. Adam Anz presents “Articular Cartilage Regeneration with Autologous Peripheral Blood Stem Cells” during  American Academy of Orthopaedic Surgeons Annual meeting in Chicago

This year’s AAOS meeting, held in Chicago, boasted educational courses and lectures on a variety of orthopaedic topics including hip and knee reconstruction, basic research,  sports medicine, and arthroscopy.  Dr. Adam Anz had the privilege to present the technique and data from his upcoming publication with Dr. Saw, Articular Cartilage Regeneration with Autologous Peripheral Blood Stem Cells and Hyaluronic Acid:  A Randomized Controlled Trial.  This article will be published in the April 2013 edition of the orthopaedic journal Arthroscopy. The section in which Dr. Anz presented included research on cartilage from all over the world and was attended by some of the leading researchers in knee cartilage techniques.
US-Ski-Team

Dr. Adam Anz Provides Physician Coverage for the US Ski Team During World Cup Races in Ofterschwang, Germany

US-Ski-TeamDr. Adam Anz, orthopaedic knee and hip surgeon and sports medicine specialist in Gulf Breeze, Florida, recently returned from Ofterschwang, Germany where he provided physician coverage for the USSA women’s technical team during the Audi FIS Alpine Ski World Cup.  During this event, ski racers competed in giant slalom and slalom competitions.  Mikaela Shiffrin, the 2013 World Cup Champion in women’s slalom, was among the ski racers competing in Ofterschwang and finished 3rd in the slalom competition on Sunday March 10th.

Andrews Institute Exterior

Surgery Information

Andrews Institute Exterior

The Andrews Institute is a state-of-the-art facility that utilizes advanced medical tools and equipment for each surgical procedure. 

If during your consultation with Dr. Anz it has been determined that a surgical treatment will be your next step towards treating your condition or injury. W lole offer our patients an organized and relaxed setting so that your surgery takes place on time and without worry. Our patients are always cared for by board certified anesthesia doctors and trained nurses who specialize in regional anesthesia to minimize postoperative pain.

Dr. Anz will discuss the surgical technique with his patients in detail and will also provide a specific set of guidelines for pre-operative, post-operative and rehabilitation. Before surgery, you will receive a physical examination that may include blood work, EKG’s and X-rays. If these routine tests are required, they will be performed a few days before your scheduled surgical procedure.

Below, you will find the most recent pre-operative and post-operative forms for Dr. Anz:

Post-Operative Forms:

 

Orthopedic Surgery Dr. Adam Anz

For additional information, or if you would like to schedule an appointment please contact the Gulf Breeze, Florida orthopedic surgeon, Dr. Adam Anz located at the Andrews Institute. 

Medical Insurance Dr. Adam Anz

Payment and Insurance

Medical Insurance Dr. Adam Anz

Dr. Anz requests that payment be made at the time of service.  Our office accepts many insurance policies and we will collect the necessary co-pay also at the time of service.  Since the majority of insurance plans do not reimburse the full amount due, you will be responsible for any remaining balance not covered under your plan.   If you have any questions regarding your coverage or account balance, please contact our business office at 850-916-8463.

Dr. Anz is proud to accept the insurance plans under the providers listed below:

  • Aetna
  • BCBS AL
  • BCBS FL
  • BCBS FL Health Options
  • CIGNA
  • HUMANA
  • HUMANA Gold Choice
  • Medicare
  • Medicaid
  • Multiplan
  • Tricare Standard
  • Tricare Srime
  • VOC rehab
  • United Healthcare
  • US Department of Labor

For additional information, or if you would like to schedule an appointment with Dr. Adam W. Anz, Gulf Breeze, Florida orthopedic surgeon and sports medicine specialist, please contact our office today.

Football Injury Dr. Adam Anz

Dr. Adam Anz Presents During the Andrews Institute Injuries in Football Course

Football Injury Dr. Adam Anz

The Injuries in Football Course, held in Destin, Florida, provides an opportunity for orthopaedic surgeons, sports physicians, athletic trainers, physical therapists, and other professionals working with football athletes at various levels to learn more about assessment and treatment of football related injuries, the prevention of injuries, and rehabilitation.

Dr. Anz had the opportunity to address the attendees during three lectures about “Hip Injuries in Football”, “The Anatomy, Physical Examination, and Non-Operative Management of Shoulder Instability”, and “Complex Knee Injury”.  The course was well attended and presented an opportunity to bridge the gap between health care providers involved in the care of football players on all levels.

Dr.Anz-International-Trip

Malaysian Visit Discussing the Use of Orthopaedic Stem Cell Therapy

Meeting with Malaysian Government Officials goes well and the potential use of orthopaedic stem cell therapy in the USA progresses during Dr. Anz’s recent visit with Dr. Saw in Kuala Lumpur

Dr.Anz-International-TripIn February, Dr. Adam Anz had the opportunity to join Dr. Kay Yong Saw in Kuala Lumpur, Malaysia for a meeting with Malaysian Government officials including Dato Sri Idris Jala, the Malayisan minister of the Economy Planning Unit, Dato Sri Liow, the Malaysian minister of the Ministry of Health, and Sato Azmi, the Malaysian Ministry of Health Innovation Sector. This is Dr. Anz’s 4th visit to Kuala Lumpur to continue a collaboration with Dr. Saw which began in 2009. The main topic of discussion was how to progress the necessary steps for the application to the FDA for approval of the use of peripheral blood stem cell therapy in the United States. Dr. Anz has spent many weeks with Dr. Saw over the past 4 years, learning about his innovative stem cell techniques and working to bring this technology to the United States. Dr. Anz and Dr. Saw are currently working with the FDA to complete the steps needed to safely and properly provide this therapy in the USA. Their first article together regarding this technique was published in The Journal of Arthroscopic and Related Surgery in April of 2011. Complete article: Articular Cartilage Regeneration with Auto PBPC and HA.

Dr.Anz-Malaysian-TripOn the last day of the visit, Dr. Anz was presented with fruit during the lion dance representing a blessing for the year to come. During the Visit Dr. Anz also visited with local Medical Students from Taylors University in Kuala Lumpur and presented to then on “Hip Pain in the Athlete” and illustrated the physical examination of the hip.

 

Baseball Injury Dr. Adam Anz

Dr. Anz Gives Instructional Course on Elbow Anatomy During ASMI Injuries in Baseball

Baseball Injury Dr. Adam Anz

Dr. Adam Anz Gives Instruction on Elbow Anatomy and Physical Examination with Dr. James Andrews and Dr. Neal ElAttrache During American Sports Medicine Institute Injuries in Baseball Course

This January 25-27 the American Sports Medicine Institute held its 31st annual Injuries in Baseball Course in Phoenix, Arizona. This is an annual program that provides a setting to share knowledge of the various aspects of baseball healthcare and is attended by physicians, athletic trainers, physical therapists, coaches, and players from all levels of baseball.

This year, Dr. Anz had the honor of joining Dr. James Andrews and Dr. Neal ElAttrache in a live demonstration of the physical examination of the elbow. They showed performed physical examination tests and discussed pearls of elbow examination. Dr. Anz also presented on the anatomy of the elbow, presenting a video shot at the Andrews Institute regarding the surgical anatomy of the elbow. To learn more about this course please, click here.