Femoroacetabular impingement: Treatment options-Open femoral osteochondroplasty and rim trimming

The goal of femoroacetabular impingement (FAI) treatment is restoration of normal hip function by removing pathomechanic deformities. The efficacy of surgical treatment has been demonstrated for both arthroscopic and open surgery. Cam deformity on the head-neck junction and localized acetabular overcover are the domain of arthroscopic treatment. Instead, open surgery with hip dislocation is indicated in more global deformities and when additional axial corrections and/or trochanteric advancement are necessary. Surgical dislocation of the hip is a safe approach with low risk of avascular necrosis and little morbidity. It provides complete visualization of acetabulum and femoral head; furthermore, if needed, it can be extended to the proximal femur. When additional periacetabular osteotomy is indicated, the first ischial cut can be executed through this approach. In this paper, description of surgical hip dislocation technique, open femoral osteochondroplasty, and acetabular rim trimming are provided.