Femoroacetabular impingement and labral tears

Recently, femoroacetabular impingement has been recognized as a cause of groin pain and other hip mechanical symptoms (locking, catching). Beside femoral deformities associated with slipped capital femoral epiphysis or other childhood disorders leading to femoral neck enlargement, most of femora acetabular impingement are due to cam or pincer mechanisms. These anatomical abnormity produce dynamic disorders of hip that results in a pattern fo labrum-chondral damages that could be a pre state of osteoarthritis. This conditions occur in young or middle-agged patients, with frequent excessive demand on hip flexion. Imaging studies include plain radiographs and a cross table lateral view of the femoral neck; it can identified retroversion feature of the acetabulum or an anormal head-neck femoral junction. Measurement are best done on computed tomography or magnetic resonance imaging. Full imaging of these hips must include intra-articular opacification which can assess labral fixation and lesion, and chondral damage. Treatment generally rely on surgical debridement of the anatomical abnormality by open approach and dislocation of the hip. The attitude to labral tears and cartilage damage is still under discussion. In a attempt to reduce morbidity and accelerate rehabilitation, some teams treated these femoroacetabular impingement arthroscopically or with combined arthroscopic and minimal anterior approach of the hip.