Femoroacetabular impingement (FAI)

FAI occurs when the hip bones do not form normally during childhood and early adulthood. This is commonly seen in certain athletes such as hockey and soccer players, but can occur in anyone. This malformation can cause the bones to rub against each other during certain movements. Over time, this friction can damage the hip joint and lead to conditions like hip labral tears or hip arthritis.

• Pincer impingement is when extra bone extends out over the normal rim of the acetabulum, leading to the labrum being crushed under the rim of the hip socket.
• Cam impingement is when the femoral head is not round and cannot rotate smoothly inside the acetabulum. The result is a bump that forms on the edge of the femoral head that grinds the cartilage inside the acetabulum.
• Combined impingement is when both the pincer and cam types are present.

Symptoms of FAI may include:

• Pain in the groin or outer hip area, often worsened by prolonged sitting or certain hip movements
• Stiffness or reduced range of motion in the hip
• A clicking, locking, or catching sensation in the hip
• Pain that radiates down the thigh towards the knee

Diagnosing FAI involves a physical examination where your hip surgeon Dr. Ben Mayo will move your hip joint in various positions to check for pain and range of motion. Imaging tests, such as X-rays, MRIs, and CT scans can provide a detailed view of your hip joint and help confirm the diagnosis. In some cases, a diagnostic injection may be used to determine if the pain is coming from the hip joint, or a different part of your hip like your muscles or tendons.

Treatment for FAI aims to relieve pain and improve function in the hip joint. Conservative options include:

• Physical therapy: Specific exercises can improve hip strength and flexibility, reducing symptoms.
• Medication: Nonsteroidal anti-inflammatory drugs (NSAIDs) can help control pain and inflammation.
• Injections: Corticosteroid injections can provide temporary relief of hip pain.

If conservative treatments fail to alleviate symptoms, or if the FAI is severe, surgery may be recommended. The most common surgical procedure for FAI is hip arthroscopy, where Dr. Mayo removes the excess bone or repairs the damaged tissues.