Buzin Scott, Shankar Dhruv, Vasavada Kinjal, Youm Thomas
Department of Orthopaedic Surgery, NYU Langone Health, New York, NY, USA.
Orthop Res Rev. 2022 Apr 21;14:121-132. doi: 10.2147/ORR.S253762. eCollection 2022.
Femoroacetabular impingement (FAI) has emerged as a common cause of hip pain, especially in young patients. While the exact cause of FAI is unknown, it is thought to result from repetitive microtrauma to the proximal femoral epiphysis leading to abnormal biomechanics. Patients typically present with groin pain that is exacerbated by hip flexion and internal rotation. Diagnosis of FAI is made through careful consideration of patient presentation as well as physical exam and diagnostic imaging. Use of radiographs can help diagnose both cam and pincer lesions, while the use of MRI can diagnose labral tears and cartilage damage associated with FAI. Both non-operative and surgical options have their role in the treatment of FAI and its associated labral tears; however, hip arthroscopy has had successful outcomes when compared with physical therapy alone. Unfortunately, chondral lesions associated with FAI have had poorer outcomes with a higher conversion rate to arthroplasty. Capsular closure following hip arthroscopy has shown superior clinical outcomes and therefore should be performed if possible. More recently, primary labral reconstruction has emerged in the literature as a good option for irreparable labral tears. While non-operative management may have its role in treating patients with FAI, hip arthroscopy has developed a successful track record in being able to treat cam and pincer lesions, chondral damage, and labral injuries.
股骨髋臼撞击症（FAI）已成为髋部疼痛的常见原因，尤其是在年轻患者中。虽然FAI的确切病因尚不清楚，但一般认为是由于股骨近端骨骺反复受到微创伤，导致生物力学异常所致。患者通常表现为腹股沟疼痛，在髋关节屈曲和内旋时会加重。FAI的诊断需要仔细考虑患者的症状表现、体格检查以及诊断性影像学检查。X线片有助于诊断凸轮型和钳夹型损伤，而MRI则可以诊断与FAI相关的盂唇撕裂和软骨损伤。非手术和手术治疗方法在FAI及其相关盂唇撕裂的治疗中都有各自的作用；然而，与单纯物理治疗相比，髋关节镜手术取得了较好的治疗效果。不幸的是，与FAI相关的软骨损伤治疗效果较差，关节置换术的转化率较高。髋关节镜检查后进行关节囊闭合已显示出更好的临床效果，因此应尽可能实施。最近，在文献中，初次盂唇重建已成为治疗不可修复的盂唇撕裂的一个不错选择。虽然非手术治疗可能在FAI患者的治疗中发挥作用，但髋关节镜手术在治疗凸轮型和钳夹型损伤、软骨损伤及盂唇损伤方面已取得了成功的记录。
