Skip to main content
Erschienen in: Journal of Children's Orthopaedics 1/2012

01.03.2012 | Original Clinical Article

Femoro-acetabular impingement: the diagnosis—a review

verfasst von: Alfred D. Grant, Debra A. Sala, Ran Schwarzkopf

Erschienen in: Journal of Children's Orthopaedics | Ausgabe 1/2012

Einloggen, um Zugang zu erhalten

Abstract

Background

The recognition of the importance of femoral acetabular impingement (FAI) as a potential cause of hip pain has been stimulated by major efforts to salvage hip joints by reconstruction in order to prevent or delay the need for replacement. The purpose of this review is to define the nature of FAI, the various types, and how to make the diagnosis.

Methods

The review describes the characteristics of the hip that cause FAI and emphasizes understanding that the femoral and acetabular components normally function as a unit, complementing each other.

Results/Conclusion

The methods of making the diagnosis of FAI and their limitations are described. If the acetabulum and femur are considered to be independent of each other, conflict may occur, hindering function, and not be apparent. The increasing frequency of making this diagnosis based on abnormal anatomy on one side of the joint, often in face of unclear physical findings, can bring the diagnosis into question. FAI seen in Perthes disease and acetabular dysplasia is explained. Knowing how to analyze the hip, being aware of the limitations of various available clinical and diagnostic studies, and recognizing the continued and ever-changing extensive body of literature is important and challenging. This primer is just the beginning.
Literatur
1.
Zurück zum Zitat Lavigne M, Parvizi J, Beck M, Siebenrock KA, Ganz R, Leunig M (2004) Anterior femoroacetabular impingement: part I. Techniques of joint preserving surgery. Clin Orthop Relat Res 418:61–66PubMedCrossRef Lavigne M, Parvizi J, Beck M, Siebenrock KA, Ganz R, Leunig M (2004) Anterior femoroacetabular impingement: part I. Techniques of joint preserving surgery. Clin Orthop Relat Res 418:61–66PubMedCrossRef
2.
Zurück zum Zitat Tönnis D, Heinecke A (1999) Acetabular and femoral anteversion: relationship with osteoarthritis of the hip. J Bone Joint Surg Am 81:1747–1770PubMed Tönnis D, Heinecke A (1999) Acetabular and femoral anteversion: relationship with osteoarthritis of the hip. J Bone Joint Surg Am 81:1747–1770PubMed
3.
Zurück zum Zitat Kalberer F, Sierra RJ, Madan SS, Ganz R, Leunig M (2008) Ischial spine projection into the pelvis: a new sign for acetabular retroversion. Clin Orthop Relat Res 466:677–683PubMedPubMedCentralCrossRef Kalberer F, Sierra RJ, Madan SS, Ganz R, Leunig M (2008) Ischial spine projection into the pelvis: a new sign for acetabular retroversion. Clin Orthop Relat Res 466:677–683PubMedPubMedCentralCrossRef
4.
Zurück zum Zitat Tannast M, Siebenrock KA (2009) Conventional radiographs to assess femoroacetabular impingement. Instr Course Lect 58:203–212PubMed Tannast M, Siebenrock KA (2009) Conventional radiographs to assess femoroacetabular impingement. Instr Course Lect 58:203–212PubMed
5.
Zurück zum Zitat Jamali AA, Mladenov K, Meyer DC, Martinez A, Beck M, Ganz R, Leunig M (2007) Anteroposterior pelvic radiographs to assess acetabular retroversion: high validity of the “cross-over-sign”. J Orthop Res 25:758–765PubMedCrossRef Jamali AA, Mladenov K, Meyer DC, Martinez A, Beck M, Ganz R, Leunig M (2007) Anteroposterior pelvic radiographs to assess acetabular retroversion: high validity of the “cross-over-sign”. J Orthop Res 25:758–765PubMedCrossRef
6.
Zurück zum Zitat Reynolds D, Lucas J, Klaue K (1999) Retroversion of the acetabulum. A cause of hip pain. J Bone Joint Surg Br 81:281–288PubMedCrossRef Reynolds D, Lucas J, Klaue K (1999) Retroversion of the acetabulum. A cause of hip pain. J Bone Joint Surg Br 81:281–288PubMedCrossRef
7.
Zurück zum Zitat Tannast M, Siebenrock KA, Anderson SE (2007) Femoroacetabular impingement: radiographic diagnosis—what the radiologist should know. AJR Am J Roentgenol 188:1540–1552PubMedCrossRef Tannast M, Siebenrock KA, Anderson SE (2007) Femoroacetabular impingement: radiographic diagnosis—what the radiologist should know. AJR Am J Roentgenol 188:1540–1552PubMedCrossRef
8.
Zurück zum Zitat Siebenrock KA, Kalbermatten DF, Ganz R (2003) Effect of pelvic tilt on acetabular retroversion: a study of pelves from cadavers. Clin Orthop Relat Res 407:241–248PubMedCrossRef Siebenrock KA, Kalbermatten DF, Ganz R (2003) Effect of pelvic tilt on acetabular retroversion: a study of pelves from cadavers. Clin Orthop Relat Res 407:241–248PubMedCrossRef
9.
Zurück zum Zitat Tannast M, Zheng G, Anderegg C, Burckhardt K, Langlotz F, Ganz R, Siebenrock KA (2005) Tilt and rotation correction of acetabular version on pelvic radiographs. Clin Orthop Relat Res 438:182–190PubMedCrossRef Tannast M, Zheng G, Anderegg C, Burckhardt K, Langlotz F, Ganz R, Siebenrock KA (2005) Tilt and rotation correction of acetabular version on pelvic radiographs. Clin Orthop Relat Res 438:182–190PubMedCrossRef
10.
Zurück zum Zitat Ilizaliturri VM Jr, Byrd JW, Sampson TG, Guanche CA, Philippon MJ, Kelly BT, Dienst M, Mardones R, Shonnard P, Larson CM (2008) A geographic zone method to describe intra-articular pathology in hip arthroscopy: cadaveric study and preliminary report. Arthroscopy 24:534–539PubMedCrossRef Ilizaliturri VM Jr, Byrd JW, Sampson TG, Guanche CA, Philippon MJ, Kelly BT, Dienst M, Mardones R, Shonnard P, Larson CM (2008) A geographic zone method to describe intra-articular pathology in hip arthroscopy: cadaveric study and preliminary report. Arthroscopy 24:534–539PubMedCrossRef
11.
Zurück zum Zitat Dandachli W, Kannan V, Richards R, Shah Z, Hall-Craggs M, Witt J (2008) Analysis of cover of the femoral head in normal and dysplastic hips: new CT-based technique. J Bone Joint Surg Br 90:1428–1434PubMedCrossRef Dandachli W, Kannan V, Richards R, Shah Z, Hall-Craggs M, Witt J (2008) Analysis of cover of the femoral head in normal and dysplastic hips: new CT-based technique. J Bone Joint Surg Br 90:1428–1434PubMedCrossRef
12.
Zurück zum Zitat Dandachli W, Islam SU, Liu M, Richards R, Hall-Craggs M, Witt J (2009) Three-dimensional CT analysis to determine acetabular retroversion and the implications for the management of femoro-acetabular impingement. J Bone Joint Surg Br 91:1031–1036PubMedCrossRef Dandachli W, Islam SU, Liu M, Richards R, Hall-Craggs M, Witt J (2009) Three-dimensional CT analysis to determine acetabular retroversion and the implications for the management of femoro-acetabular impingement. J Bone Joint Surg Br 91:1031–1036PubMedCrossRef
13.
Zurück zum Zitat Kiyama T, Naito M, Shiramizu K, Shinoda T (2009) Postoperative acetabular retroversion causes posterior osteoarthritis of the hip. Int Orthop 33:625–631PubMedPubMedCentralCrossRef Kiyama T, Naito M, Shiramizu K, Shinoda T (2009) Postoperative acetabular retroversion causes posterior osteoarthritis of the hip. Int Orthop 33:625–631PubMedPubMedCentralCrossRef
14.
Zurück zum Zitat Siebenrock KA, Schoeniger R, Ganz R (2003) Anterior femoro-acetabular impingement due to acetabular retroversion. Treatment with periacetabular osteotomy. J Bone Joint Surg Am 85:278–286PubMed Siebenrock KA, Schoeniger R, Ganz R (2003) Anterior femoro-acetabular impingement due to acetabular retroversion. Treatment with periacetabular osteotomy. J Bone Joint Surg Am 85:278–286PubMed
15.
Zurück zum Zitat Ganz R, Leunig M (2007) Morphological variations of residual hip dysplasia in the adult. Hip Int 17(Suppl 5):S22–S28PubMed Ganz R, Leunig M (2007) Morphological variations of residual hip dysplasia in the adult. Hip Int 17(Suppl 5):S22–S28PubMed
16.
Zurück zum Zitat Li PL, Ganz R (2003) Morphologic features of congenital acetabular dysplasia: one in six is retroverted. Clin Orthop Relat Res 416:245–253PubMedCrossRef Li PL, Ganz R (2003) Morphologic features of congenital acetabular dysplasia: one in six is retroverted. Clin Orthop Relat Res 416:245–253PubMedCrossRef
17.
Zurück zum Zitat Fujii M, Nakashima Y, Yamamoto T, Mawatari T, Motomura G, Matsushita A, Matsuda S, Jingushi S, Iwamoto Y (2010) Acetabular retroversion in developmental dysplasia of the hip. J Bone Joint Surg Am 92:895–903PubMedCrossRef Fujii M, Nakashima Y, Yamamoto T, Mawatari T, Motomura G, Matsushita A, Matsuda S, Jingushi S, Iwamoto Y (2010) Acetabular retroversion in developmental dysplasia of the hip. J Bone Joint Surg Am 92:895–903PubMedCrossRef
18.
Zurück zum Zitat Clohisy JC, Nunley RM, Carlisle JC, Schoenecker PL (2009) Incidence and characteristics of femoral deformities in the dysplastic hip. Clin Orthop Relat Res 467:128–134PubMedPubMedCentralCrossRef Clohisy JC, Nunley RM, Carlisle JC, Schoenecker PL (2009) Incidence and characteristics of femoral deformities in the dysplastic hip. Clin Orthop Relat Res 467:128–134PubMedPubMedCentralCrossRef
19.
Zurück zum Zitat Barnes JR, Thomas SR, Wedge J (2011) Acetabular coverage after innominate osteotomy. J Pediatr Orthop 31:530–533PubMedCrossRef Barnes JR, Thomas SR, Wedge J (2011) Acetabular coverage after innominate osteotomy. J Pediatr Orthop 31:530–533PubMedCrossRef
20.
Zurück zum Zitat Dora C, Mascard E, Mladenov K, Seringe R (2002) Retroversion of the acetabular dome after Salter and triple pelvic osteotomy for congenital dislocation of the hip. J Pediatr Orthop B 11:34–40PubMed Dora C, Mascard E, Mladenov K, Seringe R (2002) Retroversion of the acetabular dome after Salter and triple pelvic osteotomy for congenital dislocation of the hip. J Pediatr Orthop B 11:34–40PubMed
21.
Zurück zum Zitat Beaulé PE, O’Neill M, Rakhra K (2009) Acetabular labral tears. J Bone Joint Surg Am 91:701–710PubMedCrossRef Beaulé PE, O’Neill M, Rakhra K (2009) Acetabular labral tears. J Bone Joint Surg Am 91:701–710PubMedCrossRef
22.
Zurück zum Zitat Hack K, Di Primio G, Rakhra K, Beaulé PE (2010) Prevalence of cam-type femoroacetabular impingement morphology in asymptomatic volunteers. J Bone Joint Surg Am 92:2436–2444PubMedCrossRef Hack K, Di Primio G, Rakhra K, Beaulé PE (2010) Prevalence of cam-type femoroacetabular impingement morphology in asymptomatic volunteers. J Bone Joint Surg Am 92:2436–2444PubMedCrossRef
23.
Zurück zum Zitat Brunner A, Hamers AT, Fitze M, Herzog RF (2010) The plain beta-angle measured on radiographs in the assessment of femoroacetabular impingement. J Bone Joint Surg Br 92:1203–1208PubMedCrossRef Brunner A, Hamers AT, Fitze M, Herzog RF (2010) The plain beta-angle measured on radiographs in the assessment of femoroacetabular impingement. J Bone Joint Surg Br 92:1203–1208PubMedCrossRef
24.
Zurück zum Zitat Espinosa N, Beck M, Rothenfluh DA, Ganz R, Leunig M (2007) Treatment of femoro-acetabular impingement: preliminary results of labral refixation. Surgical technique. J Bone Joint Surg Am 89:36–53PubMed Espinosa N, Beck M, Rothenfluh DA, Ganz R, Leunig M (2007) Treatment of femoro-acetabular impingement: preliminary results of labral refixation. Surgical technique. J Bone Joint Surg Am 89:36–53PubMed
25.
Zurück zum Zitat Sink EL, Gralla J, Ryba A, Dayton M (2008) Clinical presentation of femoroacetabular impingement in adolescents. J Pediatr Orthop 28:806–811PubMedCrossRef Sink EL, Gralla J, Ryba A, Dayton M (2008) Clinical presentation of femoroacetabular impingement in adolescents. J Pediatr Orthop 28:806–811PubMedCrossRef
26.
Zurück zum Zitat Kim YJ, Novais EN (2011) Diagnosis and treatment of femoroacetabular impingement in Legg–Calvé–Perthes disease. J Pediatr Orthop 32(2 Suppl):S235–S240CrossRef Kim YJ, Novais EN (2011) Diagnosis and treatment of femoroacetabular impingement in Legg–Calvé–Perthes disease. J Pediatr Orthop 32(2 Suppl):S235–S240CrossRef
27.
Zurück zum Zitat Kim HT, Wenger DR (1997) “Functional retroversion” of the femoral head in Legg–Calvé–Perthes disease and epiphyseal dysplasia: analysis of head–neck deformity and its effect on limb position using three-dimensional computed tomography. J Pediatr Orthop 17:240–246PubMed Kim HT, Wenger DR (1997) “Functional retroversion” of the femoral head in Legg–Calvé–Perthes disease and epiphyseal dysplasia: analysis of head–neck deformity and its effect on limb position using three-dimensional computed tomography. J Pediatr Orthop 17:240–246PubMed
28.
Zurück zum Zitat Sankar WN, Flynn JM (2008) The development of acetabular retroversion in children with Legg–Calvé–Perthes disease. J Pediatr Orthop 28:440–443PubMedCrossRef Sankar WN, Flynn JM (2008) The development of acetabular retroversion in children with Legg–Calvé–Perthes disease. J Pediatr Orthop 28:440–443PubMedCrossRef
29.
Zurück zum Zitat Snow SW, Keret D, Scarangella S, Bowen JR (1993) Anterior impingement of the femoral head: a late phenomenon of Legg–Calvé–Perthes’ disease. J Pediatr Orthop 13:286–289PubMedCrossRef Snow SW, Keret D, Scarangella S, Bowen JR (1993) Anterior impingement of the femoral head: a late phenomenon of Legg–Calvé–Perthes’ disease. J Pediatr Orthop 13:286–289PubMedCrossRef
30.
Zurück zum Zitat Kuhn KM, Riccio AI, Saldua NS, Cassidy J (2010) Acetabular retroversion in military recruits with femoral neck stress fractures. Clin Orthop Relat Res 468:846–851PubMedPubMedCentralCrossRef Kuhn KM, Riccio AI, Saldua NS, Cassidy J (2010) Acetabular retroversion in military recruits with femoral neck stress fractures. Clin Orthop Relat Res 468:846–851PubMedPubMedCentralCrossRef
31.
Zurück zum Zitat Pollard TC, Villar RN, Norton MR, Fern ED, Williams MR, Murray DW, Carr AJ (2010) Genetic influences in the aetiology of femoroacetabular impingement: a sibling study. J Bone Joint Surg Br 92:209–216PubMedCrossRef Pollard TC, Villar RN, Norton MR, Fern ED, Williams MR, Murray DW, Carr AJ (2010) Genetic influences in the aetiology of femoroacetabular impingement: a sibling study. J Bone Joint Surg Br 92:209–216PubMedCrossRef
Metadaten
Titel
Femoro-acetabular impingement: the diagnosis—a review
verfasst von
Alfred D. Grant
Debra A. Sala
Ran Schwarzkopf
Publikationsdatum
01.03.2012
Verlag
Springer Berlin Heidelberg
Erschienen in
Journal of Children's Orthopaedics / Ausgabe 1/2012
Print ISSN: 1863-2521
Elektronische ISSN: 1863-2548
DOI
https://doi.org/10.1007/s11832-012-0386-2

Weitere Artikel der Ausgabe 1/2012

Journal of Children's Orthopaedics 1/2012 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

TEP mit Roboterhilfe führt nicht zu größerer Zufriedenheit

15.05.2024 Knie-TEP Nachrichten

Der Einsatz von Operationsrobotern für den Einbau von Totalendoprothesen des Kniegelenks hat die Präzision der Eingriffe erhöht. Für die postoperative Zufriedenheit der Patienten scheint das aber unerheblich zu sein, wie eine Studie zeigt.

Lever-Sign-Test hilft beim Verdacht auf Kreuzbandriss

15.05.2024 Vordere Kreuzbandruptur Nachrichten

Mit dem Hebelzeichen-Test lässt sich offenbar recht zuverlässig feststellen, ob ein vorderes Kreuzband gerissen ist. In einer Metaanalyse war die Vorhersagekraft vor allem bei positivem Testergebnis hoch.

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Klinik aktuell Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Aquatherapie bei Fibromyalgie wirksamer als Trockenübungen

03.05.2024 Fibromyalgiesyndrom Nachrichten

Bewegungs-, Dehnungs- und Entspannungsübungen im Wasser lindern die Beschwerden von Patientinnen mit Fibromyalgie besser als das Üben auf trockenem Land. Das geht aus einer spanisch-brasilianischen Vergleichsstudie hervor.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.