4/30/2023 0 Comments Ischial spine![]() ![]() In pincer-FAI, acetabular overcoverage results in abnormal contact between the acetabular rim and the femoral head–neck junction upon hip flexion or internal rotation. The resultant shearing force causes local chondrolabral separation, resulting in cartilage delamination and outside-in acetabular cartilage lesions. During participation in high-impact activities involving hip flexion, the eccentric femoral head impacts the articular cartilage of the anterosuperior acetabulum. Studies have shown that intense athletic activity during adolescence leads to increased physeal remodeling and subsequent abnormal head/neck morphology. ![]() Cam and pincer morphologies may be asymptomatic or lead to symptomatic FAI during hip range of motion (ROM).Ĭam-FAI refers to a femoral-based disorder where increased contact stress in the joint is driven by the loss of sphericity of the femoral head and decreased head–neck offset. Classically, the two most common types of anatomical morphologies that give rise to FAI are referred to as cam and pincer morphology, although other anatomic variants have also been found to contribute to FAI. More recently, FAI has been described as a motion-related clinical disorder of the hip caused by symptomatic premature contact between the proximal femur and acetabulum. The purpose of this study was to review the recent literature on open and arthroscopic management of FAI.įemoroacetabular impingement (FAI) has been historically regarded as a femoral and/or acetabular deformity, wherein the proximal femur abuts the acetabulum throughout ranges of motion, particularly during hip flexion and internal rotation. However, arthroscopy has trended toward earlier improvement, quicker recovery and faster return to sports. Studies comparing both open surgery and arthroscopy have shown comparable long-term pain reduction and improvements in clinical measures of hip function, as well as similar conversion rates to total hip arthroplasty. While surgical dislocation is regarded as the traditional gold standard, hip arthroscopy has become widely utilized in recent years. In pincer impingement cases with small lunate surfaces, reverse periacetabular osteotomy is indicated as acetabular osteoplasty can decrease an already small articular surface. This is done by correcting the femoral head–neck relationship to the acetabulum through femoral and/or acetabular osteoplasty and treatment of concomitant hip pathology. Operative intervention is indicated in symptomatic patients after failed conservative management with radiographic evidence of impingement and minimal arthritic changes of the hip, with the goal of restoring normal hip biomechanics and reducing pain. Radiographic evidence can include loss of sphericity of the femoral neck (cam impingement) and/or acetabular retroversion with focal or global overcoverage (pincer impingement). FAI can be the result of femoral head/neck overgrowth, acetabular overgrowth or both femoral and acetabular abnormalities, resulting in a loss of native hip biomechanics and pain upon hip flexion and rotation. Femoroacetabular impingement (FAI) is a common femoral and/or acetabular abnormality that can cause progressive damage to the hip and osteoarthritis. ![]()
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