Hip arthroscopy allows to accurately define and localize any chondral defect related to FAI. Both acetabular and femoral head CAM and PINCER associated lesions has been well described. To date, many concerns about their significance exist. More in detail, parafoveal chondral lesions (PCLs) are often associated with cartilage damage of other areas of the hip, and their presence could be a poor prognostic factor.

We managed to define the arthroscopic characteristics of PCLs and to establish their importance as risk factor for other chondral defects.

We retrospectively review a case-control analysis of 97 patients with a PCL artroscopic diagnosed compared to 438 patients undergoing hip arthroscopy with other hip lesions. We assessed the frequency and distribution of each cartilage damage with descriptive statistics for both groups. We conducted a contingency table analysis using Chi² (and Fisher's exact) test to evaluate the relevance of the presence of a PCL as a risk factor for other hip lesions. We also compared the preoperative modified Harris Hip Scores between the groups in order to evaluate clinical differences.

PCLs are more often associated with multiple hip chondral lesions in extensively damaged hips. Patients with PCLs are more symptomatic and have a worse quality of life. PCLs represent a risk factor for hip chondropathy and central osteophytes, labrum lesions and LT tears. PCLs are statistically related with PINCER morphotype of FAI.

The presence of PCLs is a very helpful index to the hip surgeon: it uncovers a major hip cartilage damage and the subsequent need to look for other hip lesions, especially in PINCER-type FAI. We expect to find a PCL in symptomatic patients with painful hip.