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Detecting and Treating Femoroacetabular Impingement (FAI)

FAI or “Femoroacetabular Impingement” is a condition where the hip bones are shaped abnormally and do not fit perfectly together, causing the bones to rub, which ultimately damages to the hip joint. The hip is a ball and socket joint and a low friction tissue called articular cartilage covers the surface of the ball and the socket, allowing for the smooth motion of one bone across the other. Around the joint a strong fibrocartilage called the labrum forms a tight seal and provides stability to the joint.

With FAI, bone spurs develop around the ball and/or along the socket. This excess growth causes the bones to hit against each other, rather than moving smoothly. Overtime this can tear the labrum and cause a breakdown the cartilage, also known as osteoarthritis.

There are three types of FAI: pincer, cam, and combined impingement. Pincer occurs when the socket bones extends too far over the normal rim which can crush the labrum. Cam is caused when the ball is not round and so does not rotate smoothly. This is often caused by a bump forming on the edge of the ball that grinds the cartilage. Combined simply means that both pincer and cam types are present.

FAI RecoveryMany people live long, active lives with FAI and never have problems. However, when symptoms develop, which indicate damage to the cartilage or labrum, the disease is likely to continue to develop and potentially get worse. These symptoms include pain, stiffness, and limping caused by the hip. The pain is often in the groin area or towards the outside of the hip and sharp stabbing pains may occur with turning, twisting, and squatting, or sometimes it’s just a dull ache. FAI occurs because the hip bone does not form normally during childhood and the abnormality eventually causes problems after years of activity and use.

At home, when symptoms occur, try to identify the activity which may have caused the pain. Sometimes reducing certain activities allows the hip to rest and settles down the pain. Over-the-counter anti-inflammatory medicines such as ibuprofen may help. If symptoms progress, a doctor examination is highly recommended. The doctor will examine your hip and attempt to recreate the pain and may use imaging tests such as x-rays, CT scans, and MRS scans. FAI can then be treated surgically and nonsurgically.

Nonsurgical treatment may involve activity or lifestyle changes, anti-inflammatory prescription medications, and physical therapy. Surgical treatment is available if nonsurgical methods fail. The procedure is primarily done arthroscopically with small incisions where the doctor can repair and clean out damage to the labrum and cartilage. The doctor can also trim away the bone to reduce any grinding. In the long term surgical success can fully reduce symptoms and prevent future damage. However, not all damage can be completely fixed, and in some cases it is possible for more problems to develop. Early surgery can help reduce these risks.