Beck et al. report the first published outcomes series for surgical hip dislocation with femoral offset correction for anterior FAI. 19 hips were followed for a mean 4.7 years to determine whether eliminating the mechanical impingement can prevent further hip degeneration. The paper also characterizes the intraoperative cartilage and labral damage patterns that predict success versus failure.
Before this paper, FAI was not recognized as an operable entity with defined outcomes data — labral tears were arthroscopically debrided in isolation, with roughly half of patients achieving good results and many requiring THA. This study established the selection rule that drives modern FAI practice: operate at Tönnis Grade 0–1, and do not operate (or counsel aggressively) at Grade 2.
When you see a young patient with groin pain and an aspheric femoral head, the preoperative MR-arthrogram is not optional. Finding femoral head migration into a cartilage defect predicts ongoing degeneration even after successful offset correction, and that patient needs a frank conversation about realistic expectations.
The paper also formalized the cam-vs-pincer distinction that now anchors FAI classification: cam produces cleavage lesions from shear, pincer produces rim malacia plus a counter-coup lesion from levering. Understanding which mechanism is present guides how much bone to resect and from where.
Beck et al. report the first published outcomes series for surgical hip dislocation with femoral offset correction for anterior FAI. 19 hips were followed for a mean 4.7 years to determine whether eliminating the mechanical impingement can prevent further hip degeneration. The paper also characterizes the intraoperative cartilage and labral damage patterns that predict success versus failure.
Before this paper, FAI was not recognized as an operable entity with defined outcomes data — labral tears were arthroscopically debrided in isolation, with roughly half of patients achieving good results and many requiring THA. This study established the selection rule that drives modern FAI practice: operate at Tönnis Grade 0–1, and do not operate (or counsel aggressively) at Grade 2.
When you see a young patient with groin pain and an aspheric femoral head, the preoperative MR-arthrogram is not optional. Finding femoral head migration into a cartilage defect predicts ongoing degeneration even after successful offset correction, and that patient needs a frank conversation about realistic expectations.
The paper also formalized the cam-vs-pincer distinction that now anchors FAI classification: cam produces cleavage lesions from shear, pincer produces rim malacia plus a counter-coup lesion from levering. Understanding which mechanism is present guides how much bone to resect and from where.