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Femoro-acetabular impingement (FAI): Is there still a place for open surgery?

Published in N°015 - January / February 2022
Article viewed 105 times

Femoro-acetabular impingement (FAI): Is there still a place for open surgery?

By Morgan Gauthier(1,2), Simon Damian Steppacher(2), Klaus Siebenrock(2), Didier Hannouche(1) in category UPDATE
(1) Department of Orthopaedics and Traumatology of the Motor System, University Hospital of Geneva, Switzerland - (2) Department of Orthopaedics and Traumatology of the Motor System, Inselspital, University of Bern, Switzerland / [email protected]

Femoro-acetabular impingement (FAI), described by Ganz in 2003 (1), is a frequent cause of hip joint pain in young adult athletes. Morphological alterations of the acetabulum (pincer effect), of the head-neck junction (cam effect), or femoral torsional deformities are the main causes of this dynamic impingement.

Introduction

Femoro-acetabular impingement (FAI), described by Ganz in 2003 (1), is a frequent cause of hip joint pain in young adult athletes. Morphological alterations of the acetabulum (pincer effect), of the head-neck junction (cam effect), or femoral torsional deformities are the main causes of this dynamic impingement (Figure 1).

Figure 1: Type of femoro-acetabular impingement. Femoroacetabular impingement can be related to a pincer effect (A), a cam effect (B), or a femoral torsion disorder (retrotorsion femur or acetabular retroversion for anterior impingement) (C).

 

This leads to labrum and cartilage damage, which can progress in long-term to coxarthrosis, so early diagnosis and appropriate management are essential. The questions addressed in this article are the following:

1. What imaging modalities and measurements are needed for FAI assessment
2. With the advancement of hip arthroscopy, what is the place of open surgery in the treatment of FAI.

 

Diagnosis of femoro-acetabular impingement

FAI is mainly diagnosed in young adults playing certain sports with repetitive hip movements, such as hockey, martial arts or football. More recently it has also been demonstrated in other sports such as table tennis or golf. While the pain is typically located in the groin, it...

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