Case: We describe a case of hip impingement in an 18-year-old woman in association with a large cyst at the femoral neck equal to a resection level of approximately 40%. There was great concern of femoral neck fracture. At the time of hip arthroscopy, this was prophylactically treated with cannulated screws in the femoral head and neck, and the cyst was arthroscopically bone grafted using a novel technique with instruments included in standard the arthroscopy trays.
Conclusion: Prophylactic femoral neck fixation with arthroscopic bone grafting of large bone cysts is a viable treatment option with minimal added morbidity.