Hip pain in young adults and the role of hip arthroscopy

The spectrum of recognisable hip conditions has broadened significantly over the past five years through improved imaging techniques and hip arthroscopy. Hip arthroscopy may increasingly provide new treatment options for the plethora of hip pathologies. Femoro-acetabular impingement (FAI), a condition relatively unknown until its introduction by Ganz, is now thought to be the most common cause of hip pain in the young adult with an incidence around 10–15% of the population. FAI is responsible for labral tears and chondral injuries and there is growing evidence that it is a precursor of osteoarthritis. Although there are few studies assessing open and arthroscopic treatment of FAI, the early results are promising. Labral tears may be associated with dysplasia and instability, and can be degenerative or post-traumatic. With regard to articular degeneration hip arthroscopy appears to offer some benefits in treating localized articular cartilage lesions although its role for more diffuse osteoarthritis is limited. It is likely that the hip arthroscopist will become a valuable addition to the staffing in an orthopaedic department.