Skip to main content
SpringerLink
Log in

The arthroscopic management of femoroacetabular impingement

  • Hip
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Femoroacetabular impingement (FAI) has recently been implicated in causing a spectrum of injury ranging from anterior hip pain, labral tears, chondral damage, and eventually perhaps to idiopathic arthritis of the hip. Three distinct types have been described: cam, pincer and mixed, with the mixed one being the commonest. Surgical treatment of femoroacetabular impingement is focused towards providing an adequate clearance to alleviate femoral abutment against the acetabular rim. This is achieved by restoring a normal femoral head–neck offset and recessing the acetabular rim if necessary. The treatment of FAI has been achieved with reasonable success by open surgical dislocation as described by the Swiss group. However, the protracted post-operative recovery coupled with the trauma sustained during the open procedure, have led to the development of an arthroscopic approach to manage this problem. The purpose of this article is to provide the reader with an up-to-date knowledge of the clinical and diagnostic aspects of FAI, to describe our arthroscopic technique in detail with its pitfalls and possible complications and to discuss the results and future of FAI.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Beck M, Leunig M, Parvizi J, Boutier V, Wyss D, Ganz R (2004) Anterior femoroacetabular impingement: part II. Midterm results of surgical treatment. Clin Orthop Relat Res 418:67–73

    Google Scholar 

  2. Beck M, Kalhor M, Leunig M, Ganz R (2005) Hip morphology influences the pattern of damage to the acetabular cartilage: femoroacetabular impingement as a cause of early osteoarthritis of the hip. J Bone Joint Surg Br 87(7):1012–1018

    Article  PubMed  CAS  Google Scholar 

  3. Byrd JW (1994) Hip arthroscopy utilising the supine position. Arthroscopy 10:275–280

    PubMed  CAS  Google Scholar 

  4. Clohisy JC, McClure JT (2005) Treatment of anterior femoroacetabular impingement with combined hip arthroscopy and limited anterior decompression. Iowa Orthop J 25:164–171

    PubMed  Google Scholar 

  5. Crawford JR, Villar RN (2005) Current concepts in the management of femoroacetabular impingement. J Bone Joint Surg Br 87(11):1459–1462

    Article  PubMed  CAS  Google Scholar 

  6. Dienst M, Godde S, Seil R, Hammer D, Kohn D (2001) Hip arthroscopy without traction: in vivo anatomy of the peripheral hip joint cavity. Arthroscopy 17(9):924–931

    Article  PubMed  CAS  Google Scholar 

  7. Flores RH, Hochberg MC (1998) Definition and classification of osteoarthritis. In Brandt KD, Doherty M, Lohmander LS (eds) Osteoarthritis New York. Oxford Medical Publication, Oxford University Press, Oxford, pp 1–12

  8. Ganz R, Gill TJ, Gautier E, Ganz K, Krugel N, Berlemann U (2001) Surgical dislocation of the adult hip a technique with full access to the femoral head and acetabulum without the risk of avascular necrosis. J Bone Joint Surg Br 83(8):1119–1124

    Article  PubMed  CAS  Google Scholar 

  9. Ganz R, Parvizi J, Beck M, Leunig M, Notzli H, Siebenrock KA (2003) Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res (417):112–120

  10. Glick JM, Sampson TG, Gordon RB, Behr JT, Schmidt E (1987) Hip arthroscopy by the lateral approach. Arthroscopy 3:4–12

    Article  PubMed  CAS  Google Scholar 

  11. Guanche CA, Bare AA (2006) Arthroscopic treatment of femoroacetabular impingement. Arthroscopy 22(1):95–106

    Article  PubMed  Google Scholar 

  12. Harris WH (1986) Etiology of osteoarthritis of the hip. Clin Orthop 213:20–33

    PubMed  Google Scholar 

  13. Ito K, Minka MA II, Leunig M, Werlen S, Ganz R (2001) Femoroacetabular impingement and the cam-effect. A MRI-based quantitative anatomical study of the femoral head-neck offset. J Bone Joint Surg Br 83(2):171–176

    Article  PubMed  CAS  Google Scholar 

  14. Khanduja V, Villar RN (2006) Arthroscopic surgery of the hip—current concepts and recent advances. J Bone Joint Surg Br 88(12):1557–1566

    Article  PubMed  CAS  Google Scholar 

  15. Lavigne M, Parvizi J, Beck M, Siebenrock KA, Ganz R, Leunig M (2004) Anterior femoroacetabular impingement: part I. Techniques of joint preserving surgery. Clin Orthop Relat Res 418:61–66

    Google Scholar 

  16. Leunig M, Beck M, Kalhor M, Kim YJ, Werlen S, Ganz R (2005) Fibrocystic changes at anterosuperior femoral neck: prevalence in hips with femoroacetabular impingement. Radiology 236(1):237–246

    Article  PubMed  Google Scholar 

  17. Mardones RM, Gonzalez C, Chen Q, Zobitz M, Kaufman KR, Trousdale RT (2006) Surgical treatment of femoroacetabular impingement: evaluation of the effect of the size of the resection. Surgical technique. J Bone Joint Surg Am Mar 88(Suppl 1 Pt 1):84–91

    Article  Google Scholar 

  18. Murphy S, Tannast M, Kim YJ, Buly R, Millis MB (2004) Debridement of the adult hip for femoroacetabular impingement: indications and preliminary clinical results. Clin Orthop Relat Res 429:178–181

    Google Scholar 

  19. Meyer DC, Beck M, Ellis T, Ganz R, Leunig M (2006) Comparison of six radiographic projections to assess femoral head/neck asphericity. Clin Orthop Relat Res 445:181–185

    PubMed  Google Scholar 

  20. Pfirrmann CW, Mengiardi B, Dora C, Kalberer F, Zanetti M, Hodler J (2006) Cam and pincer femoroacetabular impingement: characteristic MR arthrographic findings in 50 patients. Radiology 240(3):778–785

    Article  PubMed  Google Scholar 

  21. Philippon MJ, Schenker ML (2006) Arthroscopy for the treatment of femoroacetabular impingement in the athlete. Clin Sports Med 25(2):299–308

    Article  PubMed  Google Scholar 

  22. Sampson TG (2006) Arthroscopic treatment of femoroacetabular impingement: a proposed technique with clinical experience. Instr Course Lect 55:337–346

    PubMed  Google Scholar 

  23. Sadri H, Hoffmeyer P ( 2006) Treatment of FAI by hip arthroscopy compared to open surgery with a minimum 2 year follow-up. Presented at the advances in hip arthroscopy meeting, Paris

  24. Tanzer M, Noiseux N (2004) Osseous abnormalities and early osteoarthritis: the role of hip impingement. Clin Orthop Relat Res 429:170–177

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. The Wellington Hospital, St. John’s Wood, The Villar Suite, 1st Floor, South Building, London, NW8 9LE, UK

    Vikas Khanduja & Richard N. Villar

Authors
  1. Vikas Khanduja
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Richard N. Villar
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Richard N. Villar.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Khanduja, V., Villar, R.N. The arthroscopic management of femoroacetabular impingement. Knee Surg Sports Traumatol Arthr 15, 1035–1040 (2007). https://doi.org/10.1007/s00167-007-0319-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-007-0319-7

Keywords

Search

Navigation