Femoroacetabular Impingement: Saving the Joint

Many factors have been linked to the development of osteoarthritis (OA) of the hip, but often, cases are still considered “idiopathic.” Femoroacetabular impingement (FAI) has been suggested as a possible etiologic factor for the otherwise “idiopathic” cases. It is theorized that the subtle morphologic abnormalities seen at the head-neck junction and acetabulum in FAI may lead to labral tears, chondral damage, and subsequent progression of OA. Prevalence of FAI has been suggested to be as high as 14% in the general population. It often presents in young active patients that subject their hip joint to repetitive micro trauma associated with impingement of the osseous deformity within normal ranges of motion. Current surgical treatment options for FAI include arthroscopy, open surgical dislocation, or mini-open direct anterior osteoplasty. All methods are directed at correcting the osseous abnormalities and associated pathologies in hopes of delaying the progression of OA and the need for hip replacement. Limited short term follow-up data has shown significant improvement in pain and function following each of the three procedures. However, long term follow-up and comparative studies are necessary to evaluate the efficacy of each of the surgical approaches in delaying the progression of osteoarthritis.