The Concept of Femoroacetabular Impingement: Current Status and Future Perspectives

Abstract

Femoroacetabular impingement (FAI) is a recently proposed mechanism causing abnormal contact stresses and potential joint damage around the hip. In the majority of cases, a bony deformity or spatial malorientation of the femoral head or head/neck junction, acetabulum, or both cause FAI. Supraphysiologic motion or high impact might cause FAI even with very mild bony alterations. FAI became of interest to the medical field when (1) evidence began to emerge suggesting that FAI may initiate osteoarthritis of the hip and when (2) adolescents and active adults with groin pain and imaging evidence of FAI were successfully treated addressing the causes of FAI. With an increased recognition and acceptance of FAI as a damage mechanism of the hip, defined standards of assessment and treatment need to be developed and established to provide high accuracy and precision in diagnosis. Early recognition of FAI followed by subsequent behavioral modification (profession, sports, etc) or even surgery may reduce the rate of OA due to FAI.

Reliability of a Complication Classification System for Orthopaedic Surgery

“…Although reported data from short-to medium-term single-institution retrospective analyses indicate improvement in quality of life, pain, and function for most patients after hip preservation surgery [1,16,21], a review of the literature on outcomes of surgery for acetabular dysplasia and femoroacetabular impingement (FAI) suggests the need for validated standardized outcome measures and a standardized measure of complications associated with surgical treatment [6,7]. A validated complication grading scheme for hip preservation surgery that can be used universally will allow easier interpretation of the literature and true comparisons of the risks of different hip procedures.…”

Surgical Treatment of Femoroacetabular Impingement: A Systematic Review of the Literature

“…Over the past decade, the concept of femoroacetabular impingement (FAI) has been refined [26] and this constellation of disorders has been accepted as a common source of hip pain and dysfunction in young, active patients [11]. There is substantial evidence supporting the hypothesis that FAI is a major etiologic factor in the pathophysiology of secondary osteoarthritis of the hip [1,5,6,13,17,18,25,27,[38][39][40].…”

The prevalence of radiographic femoroacetabular impingement in younger individuals undergoing total hip replacement for osteoarthritis

“…The pathomechanical process is consequent to subtle deformities of the hip joint, leading to repeated abnormal bony contact and a sequence of articular damage, pain, and ultimately radiographic OA [1,2].…”