Indicazioni e tecnica del trattamento in chirurgia aperta dell’impingement femoro-acetabolare

Successful treatment of femoroacetabular impingement requires thorough knowledge of the impingement spectrum and precision in diagnosis. Substantial information may escape when not routinely using high-quality arthro-MRI including radial sequences. Early recognition of FAI is essential. It has to be followed by behavioral modification and even surgical treatment to eventually reduce or postpone osteoarthritis due to impingement. Physical therapy or pharmaceutical medication cannot influence the pathomechanical process or the adverse influence on the hip joint. Surgical treatment should be technically feasible and the benefit for the patient foreseeable. Open and arthroscopic techniques are not competitive; they should be applied according to the pathology rather than the surgeon’s preference.We describe here the indication and techniques of open surgery for impingement hips with rather complex pathology, the workhorse for most procedures being surgical dislocation and the extended retinacular soft tissue flap.