Evolution of Femoroacetabular Impingement Treatment: The ANCHOR Experience

Our understanding of femoroacetabular impingement (FAI) as a cause of hip pain and secondary osteoarthritis has rapidly evolved since Ganz’s description in 2003, which refined concepts described a half century earlier. The concepts of cam and pincer-type impingement continue to be better defined and have evolved from relatively simple concepts to more complex and variable disease patterns that are patient-specific. Ganz and colleagues described open treatment of FAI through the development of the surgical hip dislocation approach. Increased experience and advances in arthroscopic techniques have increasingly allowed for arthroscopic treatment of the most common FAI deformities. Yet, adequate bony correction of FAI continues to be a challenge for many surgeons and remains a common cause for revision surgery. Inferior outcomes after revision FAI surgery might indicate the importance of an accurate correction, regardless of the surgical approach, during the index surgery. Open surgical dislocation continues to play a role in the treatment of complex FAI where additional reconstruction is necessary or adequate bony correction may be inconsistently performed or inaccessible via an arthroscopic approach.