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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
NEW TECHNOLOGY FOR THE TREATMENT OF ADULT HIP AND KNEE DISORDERS
Minerva Ortopedica e Traumatologica 2012 October;63(5):365-78
Actual management of femoroacetabular impingement
Steppacher S. D., Schwab J. M., Siebenrock K. A., Tannast M.
Department of Orthopedic Surgery, University of Bern, Inselspital, Bern, Switzerland
Femoroacetabular impingement (FAI) is increasingly being recognized as a major cause of hip pain leading to early degenerative changes of the joint. The goal of this article was to give an update about the actual management of FAI including diagnosis, treatment, and results of hip preserving surgery. Diagnosis of FAI is a combination of clinical and radiographic findings. Conventional radiographs for diagnosis of FAI remain crucial. MR-arthrography of the hip including radial reconstruction is the best imaging method to describe the three-dimensional pathomorphologies and identify any chondrolabral pathologies. We present a treatment algorithm for idiopathic FAI. The principal goal of surgery is to correct the femoral and/or acetabular pathomorphologies to improve range of motion and reduce patients’ symptoms. The gold standard is the surgical hip dislocation. Hip arthroscopy has become a valuable and increasingly used alternative. The indication for a periacetabular osteotomy is excessive acetabular retroversion. For all surgical techniques consistent improvement for patients’ symptoms and quality of life have been reported in literature.