Bilateral Global Pincer-Type Femoroacetabular Impingement with CAM Lesions: Arthroscopic Management Using a Peripheral First Approach.

Introduction: Pincer type of femoroacetabular impingement might have a focal or global presentation. The global form has extreme acetabular coverage and the clinical condition of the patient is affected by the presence of an associated CAM lesion as it severely reduces the range of movements at the hip joint. Case Report: A male patient of age 54 years presented to the orthopedics outpatient department with complaints of severe restriction of movements of both hip joints, which had evolved over a few years. Examination showed severe restriction of rotation and extension of hip joint with stiffness of spine. Magnetic resonance imaging of both hip joints showed bilateral large pincer lesions and calcification of capsule of hip joint with a non-visualized anterosuperior labrum and thinning of the articular cartilage. He underwent arthroscopic rim trimming of the pincer lesions and osteoplasty of the CAM lesions by the peripheral compartment first approach. Conclusion: Although pincer and CAM lesions in the hip are relatively common, severe cases in the global form are rare and difficult to manage surgically. The arthroscopic technique with the peripheral compartment first technique is an effective solution in trimming the pincer and CAM lesions effectively and thus improving the patient's clinical condition.