There has been a marked increase in the number of hip arthroscopies performed over the past 16 years, primarily in the management of femoroacetabular impingement (FAI). Insights into the pathoanatomy of FAI, and high-level evidence supporting the clinical effectiveness of arthroscopy in the management of FAI, have fuelled this trend. Arthroscopic management of labral tears with repair may have superior results compared with debridement, and there is now emerging evidence to support reconstructive options where repair is not possible. In situations where an interportal capsulotomy is performed to facilitate access, data now support closure of the capsule in selective cases where there is an increased risk of postoperative instability. Preoperative planning is an integral component of bony corrective surgery in FAI, and this has evolved to include computer-planned resection. However, the benefit of this remains controversial. Hip instability is now widely accepted, and diagnostic criteria and treatment are becoming increasingly refined. Instability can also be present with FAI or develop as a result of FAI treatment. In this annotation, we outline major current controversies relating to decision-making in hip arthroscopy for FAI. Cite this article: Bone Joint J 2022;104-B(5):532-540.

中文翻译：

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髋关节镜治疗股骨髋臼撞击的术前和术中决策挑战。

在过去的 16 年中，髋关节镜检查的数量显着增加，主要是在股骨髋臼撞击 (FAI) 的管理中。对 FAI 病理解剖学的深入了解，以及支持关节镜在 FAI 管理中的临床有效性的高水平证据，推动了这一趋势。与清创相比，通过修复修复盂唇撕裂的关节镜治疗可能具有更好的结果，并且现在有新的证据支持无法修复的重建选择。在进行门静脉囊切开术以促进进入的情况下，数据现在支持在术后不稳定风险增加的选择性病例中闭合囊。术前计划是 FAI 骨矫正手术的一个组成部分，这已经发展到包括计算机计划的切除术。然而，这样做的好处仍然存在争议。髋关节不稳现在已被广泛接受，诊断标准和治疗也日趋完善。FAI 也可能存在不稳定性，或者由于 FAI 治疗而发展。在本注释中，我们概述了当前与 FAI 髋关节镜检查决策相关的主要争议。引用这篇文章：骨关节 J  2022；104-B(5):532-540。