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DOI: 10.1055/s-0029-1245408
© Georg Thieme Verlag KG Stuttgart · New York
Femoroacetabuläres Impingement der Hüfte beim Sportler – ein Review für Sportärzte
Femoroacetabular Impingement of the Hip in Sports – a Review for Sports PhysiciansPublication History
Publication Date:
15 September 2010 (online)

Zusammenfassung
In jüngerer Zeit wurde die Bedeutung des femoroacetabulären Impingements als Ursache von Leisten- und Hüftschmerzen bei Sportlern erkannt. Es darf heute als gesichert gelten, dass die morphologischen Auffälligkeiten zu einem progredienten Verschleiß von Labrum und Knorpel und damit zu einer frühzeitigen Coxarthrose führen. Die Patienten erleben oft eine Odyssee durch verschiedenste diagnostische und therapeutische Modalitäten, werden nicht selten sogar vergeblich an anderer Stelle operiert, bevor schließlich die korrekte Diagnose gestellt und eine adäquate Therapie eingeleitet wird. Die vorliegende Übersichtsarbeit beleuchtet die aktuelle Datenlage zur Diagnostik und Therapie des femoroacetabulären Impingements mit Blick auf die sportmedizinische Relevanz. Sie soll dem klinisch tätigen Sportmediziner helfen, diese kurzfristig für die Leistungsfähigkeit des Sportlers wichtige und langfristig bezüglich Arthrose-Entwicklung nicht minder relevante Diagnose nicht zu verpassen.
Abstract
Recently the relevance of femoroacetabular impingement as a cause of hip and groin pain in sportsmen has been recognized. The entity often poses diagnostic and therapeutic problems to the sports physician. The patients go through an odysee of different diagnostic and therapeutic modalities before the correct diagnosis is made and an adaequate therapy is implemented. Not seldom, patients get even operated at another site which is thought to cause the problems. The present review analyzes the current literature concerning diagnostic standards and therapy of femoroacetabular impingement focussing on their relevance for sports medicine. It is aimed to help the sports phycisian to recognise this entity as a cause for groin and hip pain in the athlet and realise its importance for the short term performance of the athlet and its long term significance in terms of development of early hip osteoarthrosis.
Schlüsselwörter
femoroacetabuläres Impingement - Leistenschmerz - Hüfte
Key words
femoroacetabular impingement - groin pain - hip
Literatur
- 1
Blacklock R, Rhodes R, Brown S.
Relationship between regular walking, physical activity, and health-related quality
of life.
J Phys Act Health.
2007;
4
138-152
Reference Ris Wihthout Link
- 2
Kerse N, Elley C, Robinson E et al.
Is physical activity counseling effective for older people? A cluster randomized,
controlled trial in primary care.
J Am Geriatr Soc.
2005;
53
1951-1956
Reference Ris Wihthout Link
- 3
Sguizzatto G, Garcez-Leme L, Casimiro L.
Evaluation of the quality of life among elderly female athletes.
Sao Paulo Med J.
2006;
124
304-305
Reference Ris Wihthout Link
- 4
Ekstrom H, Elmstahl S.
Pain and fractures are independently related to lower walking speed and grip strength:
results from the population study „Good Ageing in Skane”.
Acta Orthop.
2006;
77
902-911
Reference Ris Wihthout Link
- 5
Beck M, Kalhor M, Leunig M et al.
Hip morphology influences the pattern of damage to the acetabular cartilage: femoroacetabular
impingment as a cause of early osteoarthritis of the hip.
J Bone Joint Surg Br.
2005;
87
1012-1018
Reference Ris Wihthout Link
- 6
Ganz R, Parvizi J, Beck M et al.
Femoroacetabular Impingement. A Cause for Osteoarthritis of the Hip.
Clin Orthop Relat Res.
2003;
417
112-120
Reference Ris Wihthout Link
- 7
Leunig M, Beck M, Dora C et al.
Femoroacetabular impingement: trigger for the development of coxarthrosis.
Orthopäde.
2006;
35
77-84
Reference Ris Wihthout Link
- 8
Beck M, Leunig M, Parvizi J et al.
Anterior Femoroacetabular Impingement: Part II. Midterm Results of Surgical Treatment.
Clin Orthop.
2004;
418
67-73
Reference Ris Wihthout Link
- 9
Lavigne M, Parvizi J, Beck M et al.
Anterior femoroacetabular impingement: part I. Techniques of joint preserving surgery.
Clin Orthop Relat Res.
2004;
418
61-66
Reference Ris Wihthout Link
- 10
Beaulé P, Harvey N, Zaragoza E et al.
The femoral head/neck offset and hip resurfacing.
J Bone Joint Surg Br.
2007;
89
9-15
Reference Ris Wihthout Link
- 11
Tanzer M, Noiseux N.
Osseous abnormalities and early osteoarthritis: the role of hip impingement.
Clin Orthop Relat Res.
2004;
429
170-177
Reference Ris Wihthout Link
- 12
Kim W, Hutchinson C, Andrew J et al.
The relationship between acetabular retroversion and osteoarthritis of the hip.
J Bone Joint Surg Br.
2006;
88
727-729
Reference Ris Wihthout Link
- 13 Beaulé P, Hack K, Di Primio G et al. Prevalence of Cam type FAI morphology in 200 asymptmomatic volunteers. Proceedings, Annual meeting AAOS 2009
Reference Ris Wihthout Link
- 14
Takeyama A, Naito M, Shiramizu K et al.
Prevalence of femoroacetabular impingement in Asian patients with osteoarthritis of
the hip.
Int Orthop.
2009;
33
1229-1232
Reference Ris Wihthout Link
- 15
Bizzini M, Notzli H, Maffiuletti N.
Femoroacetabular Impingement in Professional Ice Hockey Players.
Am J Sports Med.
2007;
35
1955-1959
Reference Ris Wihthout Link
- 16
McCarthy J, Noble P, Schuck M et al.
The Otto E. Autofranc Award: The role of labral lesions to development of early hip
disease.
Clin Orthop.
2001;
393
25-37
Reference Ris Wihthout Link
- 17
Ito K, Minka-II M, Leunig M et al.
Femoroacetabular impingement and the cam-effect. A MRI-based quantitative anatomical
study of the femoral head-neck offset.
J Bone Joint Surg Br.
2001;
83
171-176
Reference Ris Wihthout Link
- 18
Harris W.
Etiology of osteoarthritis of the hip.
Clin Orthop.
1986;
213
20-33
Reference Ris Wihthout Link
- 19
Goodman D, Feighan J, Smith A et al.
Subclinical slipped capital femoral epiphysis. Relationship to osteoarthritis of the
hip.
J Bone Joint Surg Am.
1997;
79
1489-1497
Reference Ris Wihthout Link
- 20
Morgan J, Sommerville E.
Normal and abnormal growth at the upper end of the femur.
J Bone Joint Surg Br.
1960;
42
264-272
Reference Ris Wihthout Link
- 21
Siebenrock K, Wahab K, Werlen S et al.
Abnormal extension of the femoral head epiphysis as a cause of cam impingement.
Clin Orthop Rel Res.
2004;
418
54-60
Reference Ris Wihthout Link
- 22
Leunig M, Ganz R.
FAI – concept and etiology.
Orthopäde.
2009;
38
394-401
Reference Ris Wihthout Link
- 23
Jamali A, Mladenov K, Meyer D et al.
Anteroposterior pelvic radiographs to assess acetabular retroversion: high validity
of the „cross-over-sign”.
J Orthop Res.
2007;
25
758-765
Reference Ris Wihthout Link
- 24
Li P, Ganz R.
Morphologic features of congenital acetabular dysplasia: one in six is retroverted.
Clin Orthop Relat Res.
2003;
416
245-253
Reference Ris Wihthout Link
- 25
Dora C, Bühler M, Stover M et al.
Morphologic characteristics of acetabular dysplasia in proximal femoral focal deficiency.
J Pediatr Orthop B.
2004;
13
81-87
Reference Ris Wihthout Link
- 26
Dora C, Mascard E, Mladenov K et al.
Retroversion of the acetabular dome after Salter and triple pelvic osteotomy for congenital
dislocation of the hip.
J Pediatr Orthop B.
2002;
11
34-40
Reference Ris Wihthout Link
- 27
Crawford J, Villar R.
Current concepts in the management of femoroacetabular impingement.
J Bone Joint Surg Br.
2005;
87-B
1459-1462
Reference Ris Wihthout Link
- 28
Philippon M, Stubbs A, Schenker M et al.
Arthroscopic management of femoroacetabular impingement: osteoplasty technique and
literature review.
Am J Sports Med.
2007;
35
1571-1580
Reference Ris Wihthout Link
- 29
Leunig M, Beck M, Woo A et al.
Acetabular rim degeneration: A constant finding in the aged hip.
Clin Orthop.
2003;
413
201-207
Reference Ris Wihthout Link
- 30
Santori N, Villar R.
Arthroscopic findings in the initial stages of hip osteoarthritis.
Orthopedics.
1999;
22
405-409
Reference Ris Wihthout Link
- 31
Larson C, Giveans M.
Arthroscopic management of femoroacetabular impingement: early outcomes measures.
Arthroscopy.
2008;
24
540-546
Reference Ris Wihthout Link
- 32
Clohisy J, Knaus E, Hunt D et al.
Clinical Presentation of Patients with Symptomatic Anterior Hip Impingement.
Clin Orthop Relat Res.
2009;
467
638-644
Reference Ris Wihthout Link
- 33
Wyss T, Clark J, Weishaupt D et al.
Correlation between internal rotation and bony anatomy in the hip.
Clin Orthop.
2007;
460
152-158
Reference Ris Wihthout Link
- 34
Weir A, Vos de R, Moen M et al.
Prevalence of radiological signs of femoroacetabulr impingement in patients presenting
with long standing adductor related groin pain.
Br J Sports Med.
2009;
Epub ahead of print.
Reference Ris Wihthout Link
- 35
Nötzli H, Wyss T, Stoecklin C et al.
The contour of the femoral head-neck junction as a predictor for the risk of anterior
impingement.
J Bone Joint Surg Br.
2002;
84
556-560
Reference Ris Wihthout Link
- 36
Beaule P, Zaragoza E, Motamedi K et al.
Three-dimensional computed tomography of the hip in the assessment of femoroacetabular
impingement.
J Orthop Res.
2005;
23
1286-1292
Reference Ris Wihthout Link
- 37
Johnston T, Schenker M, Briggs K et al.
Relationship between offset angle alpha and hip chondral injury in femoroacetabular
impingement.
Arthroscopy.
2008;
24
669-675
Reference Ris Wihthout Link
- 38
Czerny C, Hofmann S, Urban M et al.
MR arthrography of the adult acetabular capsular-labral complex: Correlation with
surgery and anatomy.
Am J Radiol.
1999;
173
345-349
Reference Ris Wihthout Link
- 39
Lohan D, Seeger L, Motamedi K et al.
Cam-type femoral-acetabular impingement: is the alpha angle the best MR arthrography
has to offer?.
Skeletal Radiol.
2009;
38
855-862
Reference Ris Wihthout Link
- 40
Horisberger M, Brunner A, Herzog R.
Arthroscopic Therapy of Femoroacetabular Impingement in Patients with severe Cartilage
lesions.
Arthroscopy.
2010;
26
623-629
Reference Ris Wihthout Link
- 41
Siebenrock K, Schoeniger R, Ganz R.
Anterior femoro-acetabular impingement due to acetabular retroversion. Treatment with
periacetabular osteotomy.
J Bone Joint Surg Am.
2003;
85-A
278-286
Reference Ris Wihthout Link
- 42
Ganz R, Gill T, Gautier E et al.
Surgical dislocation of the adult hip: A technique with full access to the femoral
head and acetabulum without the risk of avascular necrosis.
J Bone Joint Surg Br.
2001;
83B
1119-1124
Reference Ris Wihthout Link
- 43
Ilizaliturri V J.
Complications of arthroscopic femoroacetabular impingement treatment: a review.
Clin Orthop Relat Res.
2009;
467
760-768
Reference Ris Wihthout Link
- 44
Laude F, Sariali E.
Treatment of FAI via a minimally invasive ventral approach with arthroscopic assistance.
Technique and midterm results.
Orthopäde.
2009;
38
419-428
Reference Ris Wihthout Link
- 45
Mardones R, Gonzalez C, Chen Q et al.
Surgical treatment of femoroacetabular impingement: evaluation of the effect of the
size of the resection.
J Bone Joint Surg Am.
2005;
87
273-279
Reference Ris Wihthout Link
- 46
Espinosa N, Rothenfluh D, Beck M et al.
Treatment of femoroacetabular impingement: Preliminary results of labral refixation.
J Bone Joint Surg Am.
2006;
88
295-935
Reference Ris Wihthout Link
- 47
Murphy S, Tannast M, Kim Y et al.
Debridement of the adult hip for femoroacetabular impingement: Indications and preliminary
clinical results.
Clin Orthop.
2004;
429
178-181
Reference Ris Wihthout Link
- 48
Peters C, Erickson J.
Treatment of Femoro-Acetabular Impingement with Surgical Dislocation and Débridement
in Young Adults.
J Bone Joint Surg Am.
2006;
88-A
1735-1741
Reference Ris Wihthout Link
- 49
Beaulé P, Le Duff M, Zaragoza E.
Quality of Life Following Femoral Head-Neck Osteochondroplasty for Femoroacetabular
Impingement.
J Bone Joint Surg Am.
2007;
89-A
773-779
Reference Ris Wihthout Link
- 50
Guanche C, Bare A.
Arthroscopic treatment of femoroacetabular impingement.
Arthroscopy.
2006;
22
95-106
Reference Ris Wihthout Link
- 51
Sampson T.
Arthroscopic treatment of femoroacetabular impingement: a proposed technique with
clinical experience.
Instr Course Lect.
2006;
55
337-346
Reference Ris Wihthout Link
- 52
Stähelin L, Stähelin T, Jolles B et al.
Arthroscopic Offset Restoration in Femoroacetabular Cam Impingement: Accuracy and
Early Clinical Outcome.
Arthroscopy.
2008;
24
51-57
Reference Ris Wihthout Link
- 53
Weiland D, Philippon M.
Arthroscopic Technique of Femoroacetabular Impingement.
Oper Tech Orthop.
2005;
15
256-260
Reference Ris Wihthout Link
- 54
Horisberger M, Brunner A, Herzog R.
Arthroscopic Treatment of Femoroacetabular Impingement of the Hip: A New Technique
to Access the Joint.
Clin Orthop Relat Res.
2009;
468
182-190
Reference Ris Wihthout Link
- 55
Bare A, Guanche C.
Hip impingement: the role of arthroscopy.
Orthopedics.
2005;
28
266-273
Reference Ris Wihthout Link
- 56
Dienst M, Kohn D.
Arthroscopic treatment of femoroacetabular impingement. Technique and results.
Orthopäde.
2009;
38
429-443
Reference Ris Wihthout Link
- 57
Ilizaliturri J r V, Orozco-Rodriguez L, Acosta-Rodríguez E et al.
Arthroscopic Treatment of Cam-Type Femoroacetabular Impingement: Preliminary Report
at 2 Years Minimum Follow-Up.
Arthroplasty.
2008;
23
226-234
Reference Ris Wihthout Link
- 58
Christensen C, Althausen P, Mittleman M et al.
The Nonarthritic Hip Score: Reliable and Validated.
Clin Orthop Relat Res.
2003;
408
75-83
Reference Ris Wihthout Link
- 59
Philippon M, Briggs K, Yen Y et al.
Outcomes following hip arthroscopy for femoroacetabular impingement with associated
chondrolabral dysfunction.
J Bone Joint Surg Br.
2009;
91
16-23
Reference Ris Wihthout Link
- 60
Laude F, Sariali E, Nogier A.
Femoroacetabular Impingement Treatment Using Arthroscopy and Anterior Approach.
Clin Orthop Relat Res.
2009;
467
747-752
Reference Ris Wihthout Link
- 61
Bardakos N, Villar R.
Predictors of progression of osteoarthritis in femoroacetabular impingement. A radiological
study with a minimum of then years follow-up.
J Bone Joint Surg Br.
2009;
91
162-169
Reference Ris Wihthout Link
- 62
Philippon M, Schenker M, Briggs K et al.
Femoroacetabular impingement in 45 professional athletes: associated pathologies and
return to sport following arthroscopic decompression.
Knee Surg Sports Traumatol Arthrosc.
2007;
15
908-914
Reference Ris Wihthout Link
- 63
Brunner A, Horisberger M, Herzog R.
Sports and recreation activity of patients with femoroacetabular impingement before
and after arthroscopic osteoplasty.
Am J Sports Med.
2009;
37
917-922
Reference Ris Wihthout Link
Dr. M. Horisberger
Orthopädische Universitätsklinik, Behandlungszentrum Bewegungsapparat, Universitätsspital
Basel
Spitalstraße 21
4031 Basel
Schweiz
Email: monika.horisberger@hotmail.com