Histology of damaged acetabular cartilage in symptomatic femoroacetabular impingement: an observational analysis

This prospective study on symptomatic adult patients with femoroacetabular impingement (FAI) who underwent open surgical intervention for management was designed to identify any obvious histological differences in the damaged acetabular cartilage within different subgroups of FAI. 20 patients underwent surgical intervention following safe surgical dislocation of the hip. There were 6 cases of cam impingement, 5 cases of pincer impingement and 9 of the mixed type. Pincer impingement cases demonstrated a characteristic focal, well-circumscribed and localized area of severe damage. On the other hand, cases with cam impingement showed a diffuse area of involvement affecting a larger surface of the acetabular cartilage, with degenerative changes, superficial erosions and some discontinuities. A small biopsy specimen of the acetabular rim including bone, cartilage and labrum from the affected zone was obtained in all cases. Histological evaluation was performed under normal and polarized light microscopy. Histological findings helped corroborate the pre-operative diagnosis and also define the unique nature of impingement and specific damage according to the type of impingement.