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Pre- and intraoperative decision-making challenges in hip arthroscopy for femeroacetabular impingement

Martin, Hannah; Robinson, Patrick; Maempel, Julian; Hamilton, David; Gaston, Paul; Safran, Martin; Murray, Iain


Hannah Martin

Patrick Robinson

Julian Maempel

David Hamilton

Paul Gaston

Martin Safran

Iain Murray


There has been a marked increase in the number of hip arthroscopies performed over the past 16 years, primarily in the management of femoroacetabular impingement (FAI). Insights into the pathoanatomy of FAI, and high-level evidence supporting the clinical effectiveness of arthroscopy in the management of FAI, have fuelled this trend. Arthroscopic management of labral tears with repair may have superior results compared with debridement, and there is now emerging evidence to support reconstructive options where repair is not possible. In situations where an interportal capsulotomy is performed to facilitate access, data now support closure of the capsule in selective cases where there is an increased risk of postoperative instability. Preoperative planning is an integral component of bony corrective surgery in FAI, and this has evolved to include computer-planned resection. However, the benefit of this remains controversial. Hip instability is now widely accepted, and diagnostic criteria and treatment are becoming increasingly refined. Instability can also be present with FAI or develop as a result of FAI treatment. In this annotation, we outline major current controversies relating to decision-making in hip arthroscopy for FAI.

Journal Article Type Article
Acceptance Date Feb 2, 2022
Online Publication Date May 1, 2022
Publication Date 2022-05
Deposit Date Apr 28, 2022
Print ISSN 2049-4394
Publisher British Editorial Society of Bone and Joint Surgery
Peer Reviewed Peer Reviewed
Volume 104-B
Issue 5
Keywords Hip, Arthroscopy, Techniques, Planning, Controversies, hip arthroscopies femoroacetabular impingement, Debridement, labral tears, capsulotomies, hip instability, arthroscopies, postoperative instability, pathoanatomy, hips
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