Femoroacetabular impingement (FAI) occurs when anatomic variation of the hip causes impingement between the femoral-head junction and the acetabular rim during functional range of motion. Cam impingement occurs when a prominent head-neck junction contacts the acetabular rim during hip flexion ( Figure 8-1 ). Pincer impingement occurs when the acetabulum has localized or global overcoverage leading to contact of the rim with the femoral head-heck junction during normal hip motion ( Figure 8-2 ).
Arthroscopic Treatment of Pincer Impingement
Establish standard arthroscopic portals and examine the hip to confirm pincer impingement ( Figure 8-3 ).
A midanterior portal (MAP) can be used to aid in anchor placement ( Figure 8-4 ; AL, anterolateral; AP, anterior; MAP, mid-anterior portal; PMAP, proximal mid-anterior portal; PALA, proximal accessory lateral; PSP, posterosuperior.).
If the pincer lesion can be seen, leave the labral-chondral junction intact and use a burr to resect the bony prominence ( Figure 8-5 ).