Femoroacetabular impingement: a review of diagnosis and management
Open Access
- 16 March 2011
- journal article
- review article
- Published by Springer Science and Business Media LLC in Current Reviews in Musculoskeletal Medicine
- Vol. 4 (1), 23-32
- https://doi.org/10.1007/s12178-011-9073-z
Abstract
Hip pain in adults has traditionally been associated with osteoarthritis in the joint. However, many young patients with hip pain do get referred to orthopaedic surgeons without arthritis. Subtle bony and soft tissues abnormalities can present with hip pain in the active young adult. These abnormalities can lead to premature arthritis. With the improvements in clinical examination for hip impingement, radiological imaging using magnetic resonance arthrography (MRA) and or computed tomograms (CT) Scans, these lesions are being detected early. Though the cause of primary osteoarthritis is unknown, it is suggested that femoro-acetabular impingement (FAI) may be responsible for the progression of the disease in these patients. FAI is a pathological condition leading to abutment between the proximal femur and the acetabular rim. Two different mechanisms are described, although a combination of both is seen in clinical practice. Cam impingement is a result of reduced anterior femoral head neck offset. Pincer lesion is caused by abnormalities on the acetabular side. FAI due to either mechanism can lead to chondral lesions and labral pathology. Patients present with groin pain and investigated with radiographs, CT and MRA. Surgery is the treatment of choice. Open or arthroscopic exploration of the hip is undertaken with bony resection to improve the femoral head neck junction with resection or repair of the damaged labrum. This may involve femoral osteochondroplasty for the cam lesion and acetabular rim resection for pincer lesion. There is no difference in outcome between open and arthroscopic surgery for FAI.Keywords
This publication has 45 references indexed in Scilit:
- Radiographic Predictors of Hip Pain in Femoroacetabular ImpingementHSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery, 2011
- Cams and Pincer Impingement Are Distinct, Not Mixed: The Acetabular Pathomorphology of Femoroacetabular ImpingementClinical Orthopaedics and Related Research, 2010
- Femoral Head-neck Junction Deformity is Related to Osteoarthritis of the HipClinical Orthopaedics and Related Research, 2010
- Femoroacetabular impingement and classification of the cam deformity: the reference interval in normal hipsActa Orthopaedica, 2010
- Arthroscopic Femoroplasty in the Management of Cam-type Femoroacetabular ImpingementClinical Orthopaedics and Related Research, 2009
- Influence of the sagittal balance of the spine on the anterior pelvic plane and on the acetabular orientationInternational Orthopaedics, 2009
- The Etiology of Osteoarthritis of the HipClinical Orthopaedics and Related Research, 2008
- The Frog-leg Lateral Radiograph Accurately Visualized Hip Cam Impingement AbnormalitiesClinical Orthopaedics and Related Research, 2007
- Current concepts in the management of femoroacetabular impingementThe Journal of Bone and Joint Surgery. British volume, 2005
- Surgical dislocation of the adult hipThe Journal of Bone and Joint Surgery. British volume, 2001