Arthroscopic treatment of femoroacetabular impingement: Technical review.

The objectives of surgical treatment of femoroacetabular impingement are to improve the symptoms and to prevent or slow the progression of osteoarthritis by improving joint clearance between the acetabular rim and the femoral neck. Arthroscopic correction of bone abnormalities and treatment of articular lesions requires the use of techniques that provide good access to the peripheral and central compartments of the hip joint. Various patient positions and portal placements have been suggested. The sequence used to access the two compartments may differ according to the option chosen. Entering the central compartment first is the most popular technique for arthroscopic hip joint access and requires joint distraction under fluoroscopic monitoring. Accessing the peripheral compartment first can be achieved without distraction and does not always require fluoroscopic guidance. Regardless of the sequence, capsulotomy greatly facilitates the therapeutic procedures that are common to all approaches. Osteoplasties are conducted after careful pre-operative planning based on various visual or fluoroscopic landmarks. Several options are available for treating articular cartilage and labral lesions.