Open AccessOverview of Treatment Options, Clinical Results, and Controversies in the Management of Femoroacetabular Impingement
Author(s) -
Jeffrey J. Nepple,
J. W. Thomas Byrd,
Klaus A. Siebenrock,
Heidi Prather,
John C. Clohisy
Publication year - 2013
Publication title -
journal of the american academy of orthopaedic surgeons
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.343
H-Index - 111
eISSN - 1095-8762
pISSN - 1067-151X
DOI - 10.5435/jaaos-21-07-s53
Subject(s) - medicine , femoroacetabular impingement , surgery , arthroscopy , deformity , articular cartilage , hip arthroscopy , clinical trial , osteoarthritis , alternative medicine , pathology
The surgical management of symptomatic femoroacetabular impingement (FAI) generally is indicated after the failure of a trial of nonsurgical treatment. Surgical planning includes an assessment of the labrochondral pathology as well as of the acetabular and proximal femoral bony deformity. Advanced articular cartilage disease generally is associated with poorer outcomes. Surgical hip dislocation and hip arthroscopy have been used, with favorable early outcomes and low complication rates. Careful patient selection is important in predicting the success of the surgical management of symptomatic FAI. A trial of nonsurgical management generally is recommended, but limited information exists regarding its success. The early outcomes of both open and arthroscopic surgical techniques demonstrate significant improvement in most patients, with relatively low rates of complications. Because poorer clinical outcomes are associated with more advanced articular cartilage degeneration, improved strategies for the earlier identification and disease staging of symptomatic patients may enhance the long-term outcomes of both nonsurgical and surgical management.