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We present the case of a 33\u2010year\u2010old man with bilateral symptomatic protrusio acetabuli\u2014the most extreme form of global pincer femoroacetabular impingement\u2014and cam femoroacetabular impingement. We demonstrate the feasibility of the arthroscopic correction of severe deformities and describe key surgical steps permitting central compartment access, subtotal acetabuloplasty, labral reconstruction, and femoroplasty of the right hip, followed by later subtotal acetabuloplasty, labral refixation, and femoroplasty of the left hip, with improved outcomes at 2 and 1 years, respectively, as measured by the nonarthritic hip score. Though challenging, global pincer impingement, even acetabular protrusion, may be successfully treated with dual\u2010portal outpatient hip arthroscopy. The modified midanterior portal enables central compartment access and extended posterior \u201creach\u201d in the arthroscopic treatment of major global pincer femoroacetabular impingement, potentially making this contraindication a historical one while respectfully challenging the \u201cglobal\u201d recommendation for open surgery in this setting.<\/jats:p>","DOI":"10.1016\/j.arthro.2012.02.028","type":"journal-article","created":{"date-parts":[[2012,5,1]],"date-time":"2012-05-01T11:17:39Z","timestamp":1335871059000},"page":"882-888","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":50,"title":["Protrusio Acetabuli: Contraindication or Indication for Hip Arthroscopy? And the Case for Arthroscopic Treatment of Global Pincer Impingement"],"prefix":"10.1002","volume":"28","author":[{"given":"Dean K.","family":"Matsuda","sequence":"first","affiliation":[{"name":"Kaiser West Los Angeles Medical Center Los Angeles California 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