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Femoroacetabular Impingement

FEMOROACETABULAR IMPINGEMENT

Femoroacetabular impingement (FAI) is a condition where the bones in the hip impinge in areas where they should not, causing pain and decreased range of motion. The hip joint is like a ball in a socket. In this condition, the neck of the ball and the edge of the socket rub against each other causing damage and pain to the hip joint. The damage can occur to the articular cartilage (the smooth white surface which covers the hip joint) or the labral tissue (the lining of the edge of the socket) during normal movement of the hip. Over time, more cartilage and labrum are lost until eventually the ball and the socket impinge on one another.
FAI impingement comes in two forms: Cam and Pincer. Most diagnoses of FAI include a combination of the Cam and Pincer forms.
CAM Impingement: The Cam form of impingement is when the edge of the ball is not perfectly round. This lack of roundness causes abnormal contact between the surfaces.

PINCER Impingement: The Pincer form of impingement is when the edge of the socket has overgrown. It covers too much of the ball resulting in the labrum being pinched by the ball edge.
 
Symptoms include:
  • Groin pain associated with hip activity
  • Pain in the front, side or back of the hip
  • Pain with deep hip flexion
  • Locking, clicking, or catching sensation in the hip (Snapping hip syndrome)
  • Restricted hip movement
  • Lower back pain
  • Pain in the buttocks or outer thigh area

 

Risk factors to suffer from FAI:
  • Athletes such as football players, weightlifters, and hockey players
  • Heavy laborers
  • Repetitive hip flexion
  • Congenital hip dislocation
  • Anatomical abnormalities of the femoral head or angle of the hip
  • Legg-Calves-Perthes disease: a form of arthritis in children where blood supply to bone is impaired causing bone breakdown.
  • Trauma to the hip

 

The diagnosis is achieved by collecting a medical history, performing a physical examination and requesting imaging studies such as X-rays, MRI scans and CT Scan.
Treatment Options
Conservative treatment options are the first line of treatment. They consist of rest, activity modification, lifestyle changes, analgesics, Physiotherapy and Injection of steroid and analgesic into the hip joint.
Surgical treatment of FAI will be offered where non-surgical options fail and/or obvious anatomical changes are seen. Hip arthroscopy is indicated to fix the femoroacetabular impingement.