Femoroacetabular Impingement

Hip arthroscopy is a unique and novel specialty within the field of joint preservation. One of the most common indications for it, femoroacetabular impingement, was first coined in 1999. Initially, femoroacetabular impingement was commonly addressed with open surgical hip dislocation, a procedure described by Reinhold Ganz, MD, and colleagues in 2001, which was considered the gold standard for surgical treatment of femoroacetabular impingement for much of the following decade. Only in the last decade did hip arthroscopy become more commonly performed for this indication. However, the anatomic complexity of the hip joint, including the proximity of neurovascular structures and the relative inelasticity of the surrounding ligaments, yielded a significant learning curve. Inevitably, surgeons undertaking hip arthroscopies face a subset of patients with continued complaints, sometimes referred to as failed hip arthroscopy syndrome. The growing popularity of hip arthroscopy has necessitated the development of specialized referral centers, which must act as a resource to the surgeon facing a patient complaining of continued pain after primary hip arthroscopy.

I perform arthroscopic labral repair when possible. The real question is whether the entire labrum, even intact sections, should be replaced by a labral graft in the common scenario of focal anterosuperior labral insufficiency typically observed in patients with femoroacetabular impingement (FAI).