Impingement of the native hip joint

▶ Impingement at the hip is a common cause of osteoarthritis. ▶ Impingement is mostly due to morphologic changes as a consequence of in utero malformation or childhood hip disease such as Legg-Calvé-Perthes disease or slipped capital femoral epiphysis. ▶ On the basis of patterns and stages of labral and chondral injuries, impingement has been classified as cam type, pincer type, or mixed cam-pincer type. ▶ The diagnosis is based on the medical history and the findings on physical examination and imaging studies. ▶ Hip impingement is a mechanical problem, and nonoperative treatment will not correct the pathomechanics. Surgical correction should be considered prior to the onset of arthritis and must be designed to protect the vascularity of the femoral head.