Femoroacetabular impingement
[2] It occurs when the ball shaped femoral head contacts the acetabulum abnormally or does not permit a normal range of motion in the acetabular socket.
[9] Inability to perform activities such as high hip flexion or prolong sitting can also be seen in individuals with FAI.
[9] FAI is characterized by abnormal contact between the proximal femur and rim of the acetabulum (hip socket).
In most cases, patients present with a deformity in the femoral head, or acetabulum, a poorly positioned femoral-acetabular junction, or any or all of the foregoing.
[10] However, there is no concrete evidence to suggest a genetic trait and instead, the most favored theory currently supports that FAI (the cam type in particular) is due to repetitive movements involving the hip (e.g. squatting) in young athletes.
Physical exam should also involve assessing passive internal rotation of the hip during flexion, as range of motion is reduced in proportion to the size of a cam lesion.
[17] Additional non-invasive ways to observe possible FAI is changes in gait that include a lower peak hip extension and internal rotation to compensate for bony growth.
[6] It is possible to perform dynamic simulation of hip motion with CT or MRI[24][25] assisting to establish whether, where, and to what extent, impingement is occurring.
[27] Studies are examining the effectiveness of screening adolescents in school and targeting at-risk individuals for education, physical therapy and decreasing participation in possibly harmful activities/sports as referenced in the epidemiology section.
[28] Conservative treatment includes physical therapy, avoidance of those activities that produce pain, and nonsteroidal anti-inflammatory drugs.
[6] The primary aim of surgery is to correct the fit of the femoral head and acetabulum to create a hip socket that reduces contact between the two, allowing a greater range of movement.
[34] Additionally, patient reported outcomes show that approximately three to six months post-operative hip arthroscopy is when pain reduction and activities of daily life are improved.
[35] Failure of hip arthroscopy is more likely to fail in older patients, females, or those who have experienced the symptoms of FAI for a long period of time.
[36] Long term, randomized controlled trials evaluating the efficacy of conservative and operative treatments are underway.
Its original description is credited to orthopedic surgeon Dr. Reinhold Ganz, who first proposed the condition as a cause for hip osteoarthritis in a publication in 2003.
[40][41] While the true diagnosis of FAI can be considered a relatively recent discovery, reports of damage to the femoroaceatabular region date back over a century ago in the orthopedic realm of medicine.
Orthopedic surgeon Dr. Reinhold Ganz can be credited with this discovery in his 2003 publication that discussed the findings and relation to hip osteoarthritis.
