Femoroacetabular Impingement (FAI)

Femoroacetabular impingement (FAI) is a condition in which extra bone grows along one or both of the bones that form the hip joint — giving the bones an irregular shape. Because they do not fit together perfectly, the bones rub against each other during movement.

 

A common cause of

 

  • Early onset hip dysfunction
  • Secondary osteoarthritis

 

Presentation

 

Symptoms

 

  • Activity related groin or hip pain, exacerbated by hip flexion
  • Difficulty sitting
  • Mechanical hip symptoms
  • Can present with gluteal or trochanteric pain
  • Due to aberrant gait mechanics

 

Imaging

 

Radiographs to assess anterior coverage of the femoral head

CT can be used as adjunct to assess for structural abnormalities

MRI best modality to evaluate for articular cartilage, and labral degeneration and tears can assess anatomy of femoral head/neck junction abnormalities

 

Treatment

 

Nonoperative

 

Observation

 

  • Indications
  • Minimally symptomatic patient
  • No mechanical symptoms
  • Operative

 

Arthroscopic hip surgery

 

  • Indications
  • Symptomatic patient
  • Mechanical symptoms

 

Total hip arthroplasty

 

  • Indications
  • Age >60 years and end-stage hip degeneration