Femoroacetabular Impingement: Diagnosis and Management, Including Open Surgical Technique

Athletic activities frequently require extreme hip range of motion, particularly flexion and internal rotation. In patients with an aspherical femoral head or overcoverage of the acetabulum, this motion causes the head-neck junction and acetabular rim to abut, resulting in femoroacetabular impingement (FAI). With time, the repetitive contact of FAI causes activity-related groin pain and structural damage to the hip joint, including cartilage delamination, labral tears, and detachment and eventually the early onset of osteoarthritis. Conservative measures, such as activity modification, are often unsuccessful in ambitious young athletic patients whom wish to compete at a high level. Surgical dislocation of the hip provides a safe means to treat FAI. This approach preserves the blood supply to the femoral head while providing 360° access to perform osteochondroplasty and labral reattachment as needed. By restoring the congruency between the femoral head and the acetabulum, this approach may allow the patient to return to high demand activities without experiencing the symptoms and progressive joint destruction seen with FAI.