The anatomy, diagnosis and pathology of femoroacetabular impingement

Abstract

Femoroacetabular impingement is a significant cause of osteoarthritis in young active individuals, whose prognosis is directly and positively influenced by early intervention to prevent irreversible joint damage. This article discusses the anatomy, examination findings, radiological features and natural history of the condition.

The prevalence of radiographic femoroacetabular impingement in younger individuals undergoing total hip replacement for osteoarthritis

“…Longitudinal studies would also be valuable in elucidating the percentage of asymptomatic individuals showing FAI radiographic signs who develop symptomatic hip OA and require THR in the future. [4]. The anatomy, diagnosis, and pathology of femoroacetabular impingement Table 1 Radiographic signs in cam impingement [6,11] Table 2 Radiographic signs in pincer impingement [6,[9][10][11] …”

“…Cam impingement is characterized by a bony prominence at the femoral head-neck junction. With hip flexion or internal rotation, the cam lesion is forced against the acetabular rim, potentially leading to cartilage avulsion and damage [3,4] (Fig. 1a).…”

“…In contrast, pincer impingement involves acetabular over-coverage of the femoral head. Impingement occurs at the limit of hip movement as the femoral head is forced against the protruding acetabulum, leading to circumferential labral injury and cartilage damage [2][3][4] (Fig. 1b).…”

ArtiFacts: Femoroacetabular Impingement—A New Pathology?

“…3A-B), a morphology that has been considered by some to be relatively ''new'' [3,19,23]. As a result of such a cam-type deformity, FAI has been attributed to rigorous high-level sports activities [13,20], which were brought to a professional level in the 20 th and 21 st century [2].…”

“…Many of these bones have been studied by anthropologists using classical methods for reasons of scant interest to surgeons [6,8,11]. But recent analyses on one skeleton from this dig, which we have performed in collaboration with the Anthropological Institute in Zürich, Switzerland, may answer a timely orthopaedic question: Is femoroacetabular impingement (FAI) a new condition [3,19,23]-a product of 20 th -century sports and activity demands [13,20]-or has it always been a part of human skeletal pathomorphology?…”