Femoroacetabular Impingement: A Common Cause of Hip Pain in Young Adults

Abstract

Conservative measures, including physical therapy, restriction of activities, core strengthening, improvement of sensory-motor, and control and nonsteroidal anti-inflammatories are the mainstays of nonsurgical treatment. However, surgical management is often necessary to allow full return to activity with options including surgical dislocation of the hip, hip arthroscopy, periacetabular and rotational osteotomies, and combined hip arthroscopy with a limited open exposure. Although the literature is replete with short-term evidence to support surgical treatment, there are currently no long-term prospective data or natural history studies examining the implications of FAI and effects of early intervention.

Femoroacetabular Impingement: Prevalent and Often Asymptomatic in Older Men: The Osteoporotic Fractures in Men Study

“…Different radiologic criteria based on pelvic radiographs have been evaluated for the diagnosis of FAI [37,46]. Among the many criteria for FAI that have been studied, the following have been reported to have high degrees of intra-and interobserver agreement on AP-view pelvis radiographs and therefore were assessed: caput-collum-diaphyseal (CCD) angle, impingement angle, and lateral center-edge (CE) angle [4,5,9,10,14,20,24,25,45,[48][49][50][51]53] (Figs. 1-3).…”

Femoroacetabular impingement: a consideration in younger adults with hip pain

“…1,2 Anatomical abnormalities may be more common than perhaps appreciated and can include femoral and acetabular dysplasia, retroverted acetabulum, pistol grip deformity of the femur, coxa profunda (deep acetabular socket) and acetabular protrusion (a central acetabular defect resulting from migration of the femoral head). 1,[3][4][5] Such anatomical abnormalities may lead to a pre arthritic state known as femoroacetabular impingement, 4 which has been suggested to predispose to subsequent development of osteoarthritis. 1,[4][5][6][7] Recognition of femoroacetabular impingement may be of particular importance among primary care physicians and other musculoskeletal care providers, because early recognition and intervention may potentially delay or even prevent the development of osteoarthritis.…”

“…1,[3][4][5] Such anatomical abnormalities may lead to a pre arthritic state known as femoroacetabular impingement, 4 which has been suggested to predispose to subsequent development of osteoarthritis. 1,[4][5][6][7] Recognition of femoroacetabular impingement may be of particular importance among primary care physicians and other musculoskeletal care providers, because early recognition and intervention may potentially delay or even prevent the development of osteoarthritis. However, despite the understanding that femoro acetabular impingement may predispose to subsequent osteoarthritis, the natural history of untreated femoroacetabular impingement and the longterm results after surgical intervention are still incompletely elucidated.…”

Femoroacetabular Impingement: A Retrospective Case Study With 8-Year Follow-Up

“…The cam (or "pistol-grip")-type impingement represents 65% to 75% of all cases of FAI. 1,3 It is characterized by a non-existent or deficient offset between the femoral head and neck, morphologically resembling a pistol handle, and is usually seen in young active men, aged 20 to 30 years [4][5][6][7] (Fig 1). The pincer type of FAI constitutes about 25% of all cases.…”

“…It is caused by acetabular abnormalities (Fig 1) and is most often encountered in middle aged, active women. [1][2][3]6,7 Fewer than 10% of patients have a combination of the 2 types. 1,3,6 FAI has been strongly linked to pain and premature degenerative changes in the hip joints of young adults.…”