femoroacetabular impingement (fai)
What is it?
In a normal hip joint, the end of the thigh bone (femur) is shaped like a ball that fits perfectly into the round shaped socket of the hip (acetabulum). Lining the acetabulum is a ring of cartilage called the labrum, which plays an important role in the stability of the joint.
In femoroacetabular impingement, or FAI, bone spurs develop around the femoral head and/or along the acetabulum. This overgrowth causes the hip bones to hit against each other and prevents smooth movement of the joint. Over time, this can result in the tearing of the labrum and breakdown of articular cartilage lining the joint. Enough damage to the articular cartilage can lead to osteoarthritis (OA).
In femoroacetabular impingement, or FAI, bone spurs develop around the femoral head and/or along the acetabulum. This overgrowth causes the hip bones to hit against each other and prevents smooth movement of the joint. Over time, this can result in the tearing of the labrum and breakdown of articular cartilage lining the joint. Enough damage to the articular cartilage can lead to osteoarthritis (OA).
What does it look like?
There are different forms of FAI:
1. Pincer. This type occurs when extra bone extends over the normal rim of the acetabulum. The labrum can be crushed under the outgrowth of bone. Typically, this form is symptomatic in females in their 40's with a background in dance.
2. Cam. This type occurs when a bump forms on the femoral neck near the edge of the femoral head. With the added bone, the femoral head cannot rotate smoothly inside the acetabulum and grinds against the labrum. Typically, this form is symptomatic in male athletes in their 20's.
3. Combined. Combined impingement just means that both the pincer and cam types are present. This is the most common form of impingement.
1. Pincer. This type occurs when extra bone extends over the normal rim of the acetabulum. The labrum can be crushed under the outgrowth of bone. Typically, this form is symptomatic in females in their 40's with a background in dance.
2. Cam. This type occurs when a bump forms on the femoral neck near the edge of the femoral head. With the added bone, the femoral head cannot rotate smoothly inside the acetabulum and grinds against the labrum. Typically, this form is symptomatic in male athletes in their 20's.
3. Combined. Combined impingement just means that both the pincer and cam types are present. This is the most common form of impingement.
How is it treated?
Conservative Treatment: Non-Surgical
1. Activity Modification. Avoiding activities that aggravate your hip may be enough to allow the joint to heal.
2. Non-steroidal anti-inflammatory medications. Drugs like ibuprofen can be provided in a prescription-strength form to help reduce pain and inflammation. These typically should be avoided for long term use due to GI side effects.
3. Physical therapy. A skilled physical therapist can prescribe specific exercises to improve the range of motion in your hip and strengthen the muscles that support the joint. This can relieve some stress on the injured labrum or cartilage.
Surgical Treatment
When conservative treatment fails, surgical intervention through hip arthroscopy may be indicated.
Many FAI problems can be treated with a "hip scope." This procedure is done through small incisions using thin instruments and a camera to repair the joint. Any damage done to the labrum or articular cartilage can be repaired and FAI can be corrected by shaving down the excess boney growth (called an "osteotomy").
1. Activity Modification. Avoiding activities that aggravate your hip may be enough to allow the joint to heal.
2. Non-steroidal anti-inflammatory medications. Drugs like ibuprofen can be provided in a prescription-strength form to help reduce pain and inflammation. These typically should be avoided for long term use due to GI side effects.
3. Physical therapy. A skilled physical therapist can prescribe specific exercises to improve the range of motion in your hip and strengthen the muscles that support the joint. This can relieve some stress on the injured labrum or cartilage.
Surgical Treatment
When conservative treatment fails, surgical intervention through hip arthroscopy may be indicated.
Many FAI problems can be treated with a "hip scope." This procedure is done through small incisions using thin instruments and a camera to repair the joint. Any damage done to the labrum or articular cartilage can be repaired and FAI can be corrected by shaving down the excess boney growth (called an "osteotomy").