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Das femoroacetabuläre Impingement

Stellenwert der manuellen Therapie und der operativen Versorgung

Femoroacetabular impingement

The importance of manual therapy and surgical treatment

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Zusammenfassung

Das Krankheitsbild des femoroacetabulären Impingements (FAI) beschreibt das schmerzhafte Vorliegen zweier Knochendeformitäten, und zwar der Nockenwellen- („cam deformity“) und der Zangendeformität („pincer deformity“). Mithilfe der klinischen und radiologischen Untersuchung lassen sich intra- und extraartikuläre Differenzialdiagnosen voneinander abgrenzen. Wurde die Diagnose FAI gestellt, sollte primär eine konservative Therapie (einschließlich Manualtherapie, Faszientraining, myofasziale Techniken) eingeleitet werden. Nach fehlgeschlagener konservativer Therapie ist die Operation, meist in Form der Hüftarthroskopie, ein probates Mittel, die knöchernen Deformitäten zu korrigieren, Begleitverletzungen zu adressieren, Schmerzen zu reduzieren und die volle sportliche Belastbarkeit wiederherzustellen. Der vorliegende Beitrag erklärt das Grundprinzip des FAI und erläutert die diagnostischen sowie therapeutischen Maßnahmen.

Abstract

Femoroacetabular impingement (FAI) presents with hip pain in the presence of two bone deformities, namely the cam and pincer deformities. Physical and radiological examinations help to distinguish between intra- and extraarticular causes of hip pain. Upon diagnosis of FAI, conservative treatment (including manual therapy, fascia training, and myofascial techniques) should be initiated. In patients with failed conservative treatment, surgery—usually hip arthroscopy—produces excellent outcomes, with correction of bone deformities, treatment of concomitant injuries, pain reduction and restoration of full sporting capacity. This article explains the principles of FAI as well as the diagnostic and therapeutic options.

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Author information

Authors and Affiliations

  1. Arcus Sportklinik, Rastatter Str. 17–19, 75179, Pforzheim, Deutschland

    M. M. Schneider, A. Zimmerer, W. Miehlke & C. Sobau

  2. Universität Witten/Herdecke, Witten, Deutschland

    M. M. Schneider & G. Reith

  3. Institut für Myologik, Niefern, Deutschland

    A. Mohr

  4. Rehamed, Pforzheim, Deutschland

    A. Mohr

  5. Klinik für Orthopädie, Unfallchirurgie und Sporttraumatologie, Krankenhaus Köln-Merheim, Köln, Deutschland

    G. Reith

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  1. M. M. Schneider
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Correspondence to M. M. Schneider.

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Interessenkonflikt

M.M. Schneider, A. Mohr, G. Reith, A. Zimmerer, W. Miehlke und C. Sobau geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren. Alle Patienten, die über Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts zu identifizieren sind, haben hierzu ihre schriftliche Einwilligung gegeben.

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Schneider, M.M., Mohr, A., Reith, G. et al. Das femoroacetabuläre Impingement. Manuelle Medizin 55, 254–264 (2017). https://doi.org/10.1007/s00337-017-0305-1

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