Femoroacetabular Impingement: Anatomy and Pathogenesis

Abstract

Femoroacetabular impingement (FAI) is an often unrecognized hip disorder in young adults that can lead to early hip osteoarthritis and a decrease in sports performance. The diagnosis and treatment of this entity have rapidly evolved in recent years. Hip arthroscopy finds its place in the treatment of this conflict, and its indications are more and more frequent. The technical challenge of this operation involves a relatively long learning curve and a good knowledge of the hip anatomy in order to minimize the risk of complications and iatrogenic lesions. In addition to intra-articular structures of the hip joint, the anatomical structures that may be affected by the main and accessory arthroscopic approach are primar-ily the lateral femorocutaneous nerve, the lateral circumflex femoral artery, the medial circumflex femoral artery, and the circumflex superior iliac artery. A little further, 3–5 cm from the main portals, we must pay attention to the femoral nerve, the sciatic nerve, the superior gluteal nerve, the profunda femoris artery, the superficial femoral artery, and the common femoral artery. The pathogenesis of femoroacetabular impingement is not fully understood. The multifactorial origin is still relevant today. We have divided factors incriminated in the genesis of FAI into three groups.