Current Concepts in the Arthroscopic Management of Femoroacetabular Impingement

Background: Femoroacetabular impingement (FAI) is a morphological hip condition involving abnormal contact between the femoral head-neck junction and the acetabular rim, potentially leading to labral tears and premature osteoarthritis. While conservative management remains the initial approach, surgical intervention is indicated for persistent symptomatic cases to address underlying osseous deformities and associated soft tissue pathology.

Objective: This review aims to provide a comprehensive overview of current concepts in the arthroscopic management of FAI, including diagnostic assessment, surgical techniques for labral and chondral injuries, and clinical outcomes.

Key Points: Diagnosis requires a combination of clinical examination, including the FADIR and FABER tests, and advanced imaging such as 3D-CT and MR arthrography. Arthroscopic intervention focuses on osteochondroplasty for cam and pincer lesions, alongside labral preservation through repair or reconstruction, which are considered superior to debridement for maintaining the hip's suction seal. Management of concomitant chondral defects involves techniques ranging from microfracture to autologous chondrocyte implantation. Although arthroscopy demonstrates high patient satisfaction and improved quality of life in short-to-mid-term studies, long-term success is influenced by the presence of pre-existing osteoarthritis and joint space narrowing. Emerging technologies, including computer-assisted navigation and robotic systems, offer potential for increased surgical precision.

Conclusion: Arthroscopic surgery is an established, effective treatment for FAI, providing significant functional improvements and pain relief. Success depends on accurate patient selection, precise correction of morphological abnormalities, and structured postoperative rehabilitation to optimize clinical recovery.