Letter to the Editor
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- Cite this article as:
- Ferrero-Manzanal, F., Lax-Pérez, R., Marín-Peña, O. et al. Clin Orthop Relat Res (2013) 471: 3718. doi:10.1007/s11999-013-3275-1
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To the editor,
We read the study, “Femoroacetabular Impingement Predisposes to Traumatic Posterior Hip Dislocation” by Steppacher et al.  with great interest.
As the authors mentioned, the proposal that femoroacetabular impingement could play a role in low-energy hip dislocations was suggested by Philippon et al. , based on the arthroscopic findings in professional athletes during active competition. There are scarce references reporting anatomic factors that predispose to posterior hip dislocation . Steppacher and colleagues’ article proposed a mechanism of fulcrum by the interaction between the nonspherical femoral head and the acetabular rim in patients with femoroacetabular impingement-type CAM . We were satisfied to read that the authors agreed with the mechanism that we recently described and represented graphically  in a case report of a young soccer player with femoroacetabular impingement that suffered from a low-energy posterior fracture-dislocation. In our publication, we also suggested other factors that could enhance posterior hip dislocation in patients with femoroacetabular impingement: retroversion of the femoral neck, retroversion of the acetabulum, and decreased acetabular depth.
The study by Steppacher et al.  shows a higher prevalence of femoroacetabular features in patients with posterior hip dislocation compared with the normative data of the proposed mechanism. We believe posterior low-energy hip dislocation should not only be attributed to femoroacetabular impingement as an isolated mechanism. Further investigations should be performed to rule out the contributing factors in this entity.