Treatment of pincer-type femoroacetabular impingement

 

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Abstract

Pincer femoroacetabular impingement (FAI) consists of pathological contact between the acetabular labrum and rim and the femoral head-neck junction. Manifold conditions underlie pincer FAI: anatomical abnormalities, malorientation of the acetabulum, torsional abnormalities of the neck and femoral shaft (these defects can be constitutional, post-traumatic or post-surgical), and involvement in sports characterized by repeated and sudden maximum joint excursions. In a high percentage of cases, pincer FAI is associated with cam FAI.

The aims of surgical treatment of pincer FAI are to eliminate the cause of the contact and repair the joint damage; the surgery may be open or arthroscopic, performed with an articular or extra-articular approach. Recently, arthroscopic treatment of FAI had a rapid and widespread diffusion due to the advantages it offers compared with the open technique. Arthroscopic treatment can repair the joint damage and in some cases, characterized by minor deformity, compensate for extra-articular defects. The acetabular labrum must always be preserved and sutured; only in extreme cases can it be sacrificed. Post-operative mobilization must respect the healing time of the labral repair.