Abstract
Introduction: The femoroacetabular impingement syndrome is being increasingly accepted as a so-called etiologic factor X of hip arthrosis. It is a disease characterised by a mechanical conflict between the edge of the acetabulum and the pericapital part of the femoral neck.
This could result in incorrect orientation, or excessive depth of the acetabulum or hip socket (pincer type), or the missing femoral head offset (cam type), and very often a combination of both. Diagnostics: The position of the diagnosis is based on clinical examination - above all on a positive front, or back impingement test.
A sonographic examination is beneficial as it allows for the examination of the ventral head offset. But the basic reproducible examination is a wet skiagram - a sagittal scan and so-called axial hip.
A contrast examination - arthrography, in the authors' opinion, is of great benefit in a preoperative balance sheet. Of the computerised examinations, it is the CT scan or its 3D reconstruction which helps, and to detect a labral lesion a MRI scan, ideally with contrast (arthro-MRI), is essential.
Therapy: The possibilities of conservative therapy are limited to a regimen-oriented measures and chondroprotectives. Surgical treatment of the pincer type involves reduction of the acetabulum from the front or from the posterolateral approach (in case of a combined procedure with head modelling).
The cam type is a selection method involving controlled luxation and modelling of the head (also from the posterolateral approach). The front approach with limited possibility of examination of any labral lesion is appropriate only where apparent degenerative changes have been identified.
Conclusion: With regard to its increasing popularity (at least as regards the exponential increase in the number of publications on this subject), this relatively new diagnosis should not be difficult to determine. On the contrary, the surgical treatment should be centralised in facilities where these extensive procedures are performed on a routine basis.