Operative Techniques in Sports Medicine
Volume 15, Issue 4 , Pages 178-188 , October 2007

Femoroacetabular Impingement: Diagnosis and Management, Including Open Surgical Technique

  • Michael Leunig, MD

      Affiliations

    • Department of Orthopeadics, Hip Service, Schulthess Clinic, Zürich, Switzerland.
    • Corresponding Author InformationAddress reprint requests to Michael Leunig, MD, Department of Orthopaedics, Hip Service, Lengghalde 2, CH-8008 Zürich, Switzerland.
    • ,
  • William J. Robertson, MD

      Affiliations

    • Hospital for Special Surgery, New York, NY.
    • ,
  • Reinhold Ganz, MD

      Affiliations

    • Department of Orthopaedic Surgery, Inselspital, University of Bern, Bern, Switzerland.

References 

  1. Murphy SB, Kijewski PK, Millis MB, et al. Acetabular dysplasia in the adolescent and young adult. Clin Orthop Relat Res. 1990;261:214–223
  2. Murphy SB, Ganz R, Muller ME. The prognosis in untreated dysplasia of the hip (A study of radiographic factors that predict the outcome). J Bone Joint Surg Am. 1995;77:985–989
  3. Murray RO. The aetiology of primary osteoarthritis of the hip. Br J Radiol. 1965;38:810–824
  4. Ganz R, Parvizi J, Beck M, et al. Femoroacetabular impingement: A cause for osteoarthritis of the hip. Clin Orthop Relat Res. 2003;417:112–120
  5. Ganz R, Bamert P, Hausner P, et al. Cervico-acetabular impingement after femoral neck fracture. Unfallchirurg. 1991;94:172–175
  6. Notzli HP, Wyss TF, Stoecklin CH, et al. The contour of the femoral head-neck junction as a predictor for the risk of anterior impingement. J Bone Joint Surg Br. 2002;84:556–560
  7. Ito K, Leunig M, Ganz R. Histopathologic features of the acetabular labrum in femoroacetabular impingement. Clin Orthop Relat Res. 2004;429:262–271
  8. Beck M, Kalhor M, Leunig M, et al. Hip morphology influences the pattern of damage to the acetabular cartilage: Femoroacetabular impingement as a cause of early osteoarthritis of the hip. J Bone Joint Surg Br. 2005;87:1012–1018
  9. Beck M, Leunig M, Parvizi J, et al. Anterior femoroacetabular impingement: Part II (Midterm results of surgical treatment). Clin Orthop Relat Res. 2004;418:67–73
  10. Wagner S, Hofstetter W, Chiquet M, Mainil-Varlet P, et al. Early osteoarthritic changes of human femoral head cartilage subsequent to femoro-acetabular impingement. Osteoarthritis Cartilage. 2003;11:508–518
  11. Parvizi J, Leunig M, Ganz R. Femoroacetabular impingement. J Am Acad Orthop Surg. 2007;15:561–570
  12. Ito K, Minka MA, Leunig M, et al. Femoroacetabular impingement and the cam-effect (A MRI-based quantitative anatomical study of the femoral head-neck offset). J Bone Joint Surg Br. 2001;83:171–176
  13. Siebenrock KA, Wahab KH, Werlen S, et al. Abnormal extension of the femoral head epiphysis as a cause of cam impingement. Clin Orthop Relat Res. 2004;418:54–60
  14. Beaule PE, Le Duff MJ, Zaragoza E. Quality of life following femoral head-neck osteochondroplasty for femoroacetabular impingement. J Bone Joint Surg Am. 2007;89:773–779
  15. Siebenrock KA, Schoeniger R, Ganz R. Anterior femoro-acetabular impingement due to acetabular retroversion (Treatment with periacetabular osteotomy). J Bone Joint Surg Am. 2003;85-A:278–286
  16. Reynolds D, Lucas J, Klaue K. Retroversion of the acetabulum (A cause of hip pain). J Bone Joint Surg Br. 1999;81:281–288
  17. Leunig M, Beck M, Woo A, et al. Acetabular rim degeneration: A constant finding in the aged hip. Clin Orthop Relat Res. 2003;413:201–207
  18. McCarthy JC, Noble PC, Schuck MR, et al. The Otto E (Aufranc award: The role of labral lesions to development of early degenerative hip disease). Clin Orthop Relat Res. 2001;393:25–37
  19. Seldes RM, Tan V, Hunt J, et al. Anatomy, histologic features, and vascularity of the adult acetabular labrum. Clin Orthop Relat Res. 2001;382:232–240
  20. Robertson WJ, Kadrmas WR, Kelly BT. Arthroscopic management of labral tears in the hip: A systematic review of the literature. Clin Orthop Relat Res. 2007;455:88–92
  21. Wenger DE, Kendell KR, Miner MR, et al. Acetabular labral tears rarely occur in the absence of bony abnormalities. Clin Orthop Relat Res. 2004;426:145–150
  22. Burnett RS, Della Rocca GJ, Prather H, et al. Clinical presentation of patients with tears of the acetabular labrum. J Bone Joint Surg Am. 2006;88:1448–1457
  23. Siebenrock KA, Kalbermatten DF, Ganz R. Effect of pelvic tilt on acetabular retroversion: A study of pelves from cadavers. Clin Orthop Relat Res. 2003;407:241–248
  24. Tannast M, Siebenrock KA, Anderson SE. Femoroacetabular impingement: Radiographic diagnosis—what the radiologist should know. AJR Am J Roentgenol. 2007;188:1540–1552
  25. Jamali AA, Mladenov K, Meyer DC, et al. Anteroposterior pelvic radiographs to assess acetabular retroversion: High validity of the “cross-over-sign”. J Orthop Res. 2007;25:758–765
  26. Meyer DC, Beck M, Ellis T, et al. Comparison of six radiographic projections to assess femoral head/neck asphericity. Clin Orthop Relat Res. 2006;445:181–185
  27. Kassarjian A, Yoon LS, Belzile E, et al. Triad of MR arthrographic findings in patients with cam-type femoroacetabular impingement. Radiology. 2005;236:588–592
  28. Tonnis D. Normal values of the hip joint for the evaluation of-rays in children and adults. Clin Orthop Relat Res 119. 1976;39–47
  29. Leunig M, Podeszwa D, Beck M, et al. Magnetic resonance arthrography of labral disorders in hips with dysplasia and impingement. Clin Orthop Relat Res. 2004;418:74–80
  30. Gautier E, Ganz K, Krugel N, et al. Anatomy of the medial femoral circumflex artery and its surgical implications. J Bone Joint Surg Br. 2000;82:679–683
  31. Gibson A. Posterior exposure of the hip joint. J Bone Joint Surg Br. 1950;32-B:183–186
  32. Mardones RM, Gonzalez C, Chen Q, et al. Surgical treatment of femoroacetabular impingement: Evaluation of the effect of the size of the resection. J Bone Joint Surg Am. 2005;87:273–279
  33. Lavigne M, Kalhor M, Beck M, et al. Distribution of vascular foramina around the femoral head and neck junction: Relevance for conservative intracapsular procedures of the hip. Orthop Clin North Am. 2005;36(viii):171,6
  34. Notzli HP, Siebenrock KA, Hempfing A, et al. Perfusion of the femoral head during surgical dislocation of the hip (Monitoring by laser doppler flowmetry). J Bone Joint Surg Br. 2002;84:300–304
  35. Espinosa N, Rothenfluh D, Beck M, et al. Treatment of femoro-acetabular impingement: Preliminary results of labral refixation. J Bone Joint Surg Am. 2006;88:925–935

PII: S1060-1872(07)00074-3

doi: 10.1053/j.otsm.2007.10.001

Operative Techniques in Sports Medicine
Volume 15, Issue 4 , Pages 178-188 , October 2007

Article Tools

* Image Usage & Resolution