Pinzamiento femoroacetabular: abordaje diagnóstico y terapéutico
DOI:
https://doi.org/10.63403/re.v32i2.405Palabras clave:
pinzamiento femoroacetabular, preservación cadera, PFA, medicina deportivaResumen
El síndrome de pinzamiento femoroacetabular es una afección de la cadera del adulto joven que está caracterizada por la presencia de sobrecrecimiento óseo en el acetábulo y/o cuello femoral que a su vez predisponen a lesión del rodete acetabular (labrum), pérdida de la presión negativa intraarticular, microinestabilidad y posterior desarrollo de artrosis.
El desarrollo de técnicas de preservación de la articulación de la cadera ha permitido evitar o enlentecer la progresión de dicha secuencia, así como proporcionar mejoras en la calidad de vida y/o rendimiento deportivo de los pacientes que sufren dicha patología. El presente artículo expone conceptos actuales sobre el diagnóstico y manejo del síndrome de pinzamiento femoroacetabular, y sintetiza los resultados de la artroscopia de cadera en el adulto joven.
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Ganz R, Parvizi J, Beck M, Leunig M, Nötzli H, Siebenrock KA. Femoroacetabular Impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res. 2003;(417):112-120. doi: https://www.doi.org/10.1097/01.blo.0000096804.78689.c2. DOI: https://doi.org/10.1097/01.blo.0000096804.78689.c2
Griffin DR, Dickenson EJ, O'Donnell J, Agricola R, Awan T, Beck M, et al. The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement. Br J Sports Med. 2016 Oct;50(19):1169-1176. doi: https://www.doi.org/10.1136/bjsports-2016-096743. DOI: https://doi.org/10.1136/bjsports-2016-096743
Mohammed C, Kong R, Kuruba V, Rai V, Munazzam SW. Outcomes and complications of hip arthroscopy for femoroacetabular impingement syndrome: a narrative review. J Clin Orthop Trauma. 2024 Oct;58:102797. doi: https://www.doi.org/10.1016/j.jcot.2024.102797. DOI: https://doi.org/10.1016/j.jcot.2024.102797
Kuhns BD, Weber AE, Levy DM, Wuerz TH. The natural history of femoroacetabular impingement. Front Surg. 2015 Nov;2:58. doi: https://www.doi.org/10.3389/fsurg.2015.00058. DOI: https://doi.org/10.3389/fsurg.2015.00058
Park JW, Hwang JM, Yoo JJ. Arthroscopic treatment of femoroacetabular impingement syndrome: an updated review. Clin Orthop Surg. 2024;16(4):517-525. doi: https://www.doi.org/10.4055/cios23307. DOI: https://doi.org/10.4055/cios23307
Fortier LM, Popovsky D, Durci MM, Norwood H, Sherman WF, Kaye AD. An updated review of femoroacetabular impingement syndrome. Orthop Rev (Pavia). 2022 Aug;14(3):37513. doi: https://www.doi.org/10.52965/001c.37513. DOI: https://doi.org/10.52965/001c.37513
Thirumaran AJ, Murphy NJ, Fu K, Hunter DJ. Femoroacetabular impingement – what the rheumatologist needs to know. Best Pract Res Clin Rheumatol. 2024 Mar;38(1):101932. doi: https://www.doi.org/10.1016/j.berh.2024.101932. DOI: https://doi.org/10.1016/j.berh.2024.101932
Nepple JJ, Vigdorchik JM, Clohisy JC. What is the association between sports participation and the development of proximal femoral cam deformity?: a systematic review and meta-analysis.Am J Sports Med. 2015 Nov;43(11):2833-2840. doi: https://www.doi.org/10.1177/0363546514563909. DOI: https://doi.org/10.1177/0363546514563909
Chaudhry H, Ayeni OR. The etiology of femoroacetabular impingement: what we know and what we won’t. Sports Health. 2014 Mar;6(2):157-161. doi: https://www.doi.org/10.1177/1941738114521576. . DOI: https://doi.org/10.1177/1941738114521576
Pollard TC, Villar RN, Norton MR, Fern ED, Williams MR, Murray DW, et al. Genetic influences in the aetiology of femoroacetabular impingement: a sibling study. J Bone Joint Surg Br. 2010 Feb;92(2):209-216. doi: https://www.doi.org/10.1302/0301-620X.92B2.22850. DOI: https://doi.org/10.1302/0301-620X.92B2.22850
Hogervorst T, Eilander W, Fikkers JT, Meulenbelt I. Hip Ontogenesis: how evolution, genes, and load history shape hip morphotype and cartilotype. Clin Orthop Relat Res. 2012 Dec;470(12):3284-3296. doi: https://www.doi.org/10.1007/s11999-012-2511-4. DOI: https://doi.org/10.1007/s11999-012-2511-4
Banerjee P, McLean CR. Femoroacetabular impingement: a review of diagnosis and management. Curr Rev Musculoskelet Med. 2011 Mar;4(1):23-32. doi: https://www.doi.org/10.1007/s12178-011-9073-z. DOI: https://doi.org/10.1007/s12178-011-9073-z
Nepple JJ, Prather H, Trousdale RT, Clohisy JC, Beaulé PE, Glyn-Jones S, et al. Clinical Diagnosis of Femoroacetabular Impingement. Clinical diagnosis of femoroacetabular impingement. J Am Acad Orthop Surg. 2013; 21 Suppl 1:S16-19. doi: https://www.doi.org/10.5435/JAAOS-21-07-S16. DOI: https://doi.org/10.5435/00124635-201300001-00005
Maupin JJ, Steinmetz G, Thakral R. Management of femoroacetabular impingement syndrome: current insights. Orthop Res Rev. 2019 Aug 27;11:99-108. doi: https://www.doi.org/10.2147/ORR.S138454. DOI: https://doi.org/10.2147/ORR.S138454
Randelli F, Nocerino EA, Nicosia L, Alì M, Monti CB, Sardanelli F, et al. Image quality of hip MR arthrography with intra-articular injection of hyaluronic acid versus gadolinium-based contrast agent in patients with femoroacetabular impingement. Skeletal Radiol. 2020 Jun;49(6):937-944. doi: https://www.doi.org/10.1007/s00256-019-03366-y. DOI: https://doi.org/10.1007/s00256-019-03366-y
Reiman MP, Thorborg K, Goode AP, Cook CE, Weir A, Hölmich P. Diagnostic accuracy of imaging modalities and injection techniques for the diagnosis of femoroacetabular impingement/labral tear: a systematic review with meta-analysis. Am J Sports Med. 2017 Sep;45(11):2665-2677. doi: https://www.doi.org/10.1177/0363546516686960. DOI: https://doi.org/10.1177/0363546516686960
Pennock AT, Bomar JD, Johnson KP, Randich K, Upasani VV. Nonoperative management of femoroacetabular impingement: a prospective study.Am J Sports Med. 2018 Dec;46(14):3415-3422. doi: https://www.doi.org/10.1177/0363546518804805. DOI: https://doi.org/10.1177/0363546518804805
Anzillotti G, Iacomella A, Grancagnolo M, Bertolino EM, Marcacci M, Sconza C, et al. Conservative vs. surgical management for femoro-acetabular impingement: a
systematic review of clinical evidence. J Clin Med. 2022 Oct;11(19):5852. doi: https://www.doi.org/10.3390/jcm11195852.
Parsa A, Domb BG, Parvizi J, Tuncai I, Kobayashi N, Charr O, et al. What are the indications for surgical intervention for patients who have femoro-acetabular impingement of the hip? J Arthroplasty. 2025 Feb;40 (2 Suppl 1):S154-S155. doi: https://www.doi.org/10.1016/j.arth.2024.10.115. DOI: https://doi.org/10.1016/j.arth.2024.10.115
Ferreira GE, O'Keeffe M, Maher CG, Harris IA, Kwok WS, Peek AL, et al. The effectiveness of hip arthroscopic surgery for the treatment of femoroacetabular impingement syndrome: a systematic review and meta-analysis. J Sci Med Sport. 2021 Jan;24(1):21-29. doi: https://www.doi.org/10.1016/j.jsams.2020.06.013. DOI: https://doi.org/10.1016/j.jsams.2020.06.013
Domb BG, Prabhavalkar ON, Maldonado DR, Perez-Padilla PA. Long-term outcomes of arthroscopic labral treatment of femoroacetabular impingement in adolescents: a nested propensity-matched analysis. J Bone Joint Surg Am. 2024 Jun;106(12):1062-1068. doi: https://www.doi.org/10.2106/JBJS.23.00648. DOI: https://doi.org/10.2106/JBJS.23.00648
Domb BG, Owens JS, Lall AC, Harris WT, Kuhns BD. Ten-year outcomes in patients aged 40 years and older after primary arthroscopic treatment of femoroacetabular impingement with labral repair. Am J Sports Med. 2024 Sep;52(11):2740-2749. doi: https://www.doi.org/10.1177/03635465241270291. DOI: https://doi.org/10.1177/03635465241270291
Suarez-Ahedo C, Camacho-Galindo J, López-Reyes A, Martinez-Gómez LE, Pineda C, Domb BG. A comprehensive review of hip arthroscopy techniques and outcomes. SAGE Open Med. 2024 Jan;12:20503121231222212. doi: https://www.doi.org/10.1177/20503121231222212. DOI: https://doi.org/10.1177/20503121231222212
Jimenez AE, Lee MS, Owens JS, Paraschos OA, Maldonado DR, Domb BG. Competitive athletes who underwent hip arthroscopy with capsular repair showed greater improvement in patient-reported outcome scores compared with those who did not undergo repair. Arthroscopy. 2022 Nov;38(11):3030-3040. doi: https://www.doi.org/10.1016/j.arthro.2022.04.010. DOI: https://doi.org/10.1016/j.arthro.2022.04.010
Ouyang VW, Saks BR, Maldonado DR, Jimenez AE, Ankem HK, Sabetian PW, et al. Younger age, capsular repair, and larger preoperative alpha angles are associated with earlier achievement of clinically meaningful improvement after hip arthroscopy for femoroacetabular impingement syndrome. Arthroscopy. 2022 Jul;38(7):2195-2203. doi: https://www.doi.org/10.1016/j.arthro.2021.12.007. DOI: https://doi.org/10.1016/j.arthro.2021.12.007
Mullins K, Filan D, Carton P. PRP is not associated with improved outcomes following hip femoroacetabular impingement surgery: very low-quality evidence suggests hyaluronic acid and cell-based therapies may be beneficial-a systematic review of biological treatments. Arthrosc Sports Med Rehabil. 2022 Jun;4(4):e1557-e1573. doi: https://www.doi.org/10.1016/j.asmr.2022.05.002. DOI: https://doi.org/10.1016/j.asmr.2022.05.002
Ni C, Lin H, Yin H. A meta-analysis of the effectiveness and side effects of hip arthroscopy and open surgical dislocation in the management of femoroacetabular impingement. BMC Musculoskelet Disord. 2025 Jan;26(1):69. doi: https://www.doi.org/10.1186/s12891-025-08299-3. DOI: https://doi.org/10.1186/s12891-025-08299-3
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