Acetabular retroversion is an anatomical variant that gives rise to femoroacetabular impingement of the pincer type. Traditionally this abnormality was treated with a periacetabular osteotomy, that is an open operation in which the orientation of the acetabulum is altered so that it faces further forwards.
The development of the arthroscopic technique has, however, made us able to correct small bony abnormalities of this kind, restoring the biomechanics of the hip and preventing the mechanism of femoroacetabular impingement.
In the international literature there is a persistent disagreement about the best treatment, that is between open surgery (periacetabular osteotomy) and arthroscopy alone.
Further light is shed on this debate by a new study published in a well-known American journal. The study reported and analysed the medium-term results of patients with femoroacetabular impingement and a tear of the labrum of the acetabulum on a background of acetabular retroversion, who were treated by hip arthroscopy.
Data were collected prospectively from patients who underwent hip arthroscopy for femoroacetabular impingement and a tear of the acetabular labrum between 2008 and 2014. These patients had acetabular retroversion and had been assessed with the specific hip questionnaires. This group of patients was compared with another group without underlying acetabular retroversion.
The authors concluded that patients with femoroacetabular impingement and a tear of the acetabular labrum on a background of retroversion can be treated with advanced hip arthroscopy techniques, without the need for a periacetabular osteotomy. These patients had results comparable with those of the group of patients without acetabular retroversion.
Source: “American Journal of Sports Medicine”, May 2020
