The arthroscopic management of femoroacetabular impingement

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.