Femoroacetabular impingement: a common cause of hip pain in young patients

Clin J Sport Med, Jan 2011
Samora JB, Ng VY, Ellis TJ
Femoroacetabular impingement (FAI) is a common cause of hip complaints in young patients. Recently, a better understanding of the pathophysiology and of the morphological abnormalities of the hip has implicated femoroacetabular impingement (FAI) as a possible causative factor for early osteoarthritis. This article discusses the clinical picture, the findings of clinical examination and the radiographic features. The literature was searched in the PumMed database using words and terms based on the headings femoroacetabular impingement, hip osteoarthritis, hip arthroscopy, early osteoarthrosis and hip dislocation. The relevant studies were also checked from the bibliographic references. All the studies relevant to the treatment of femoroacetabular impingement were assessed by 3 authors and selected for further analysis, including expert opinion and review articles. The quality of each study was assessed and the results were also summarised.
The authors concluded that conservative measures, namely physiotherapy, restriction of activities, strengthening of the core muscles, improvement of the sensory and motor mechanism and the use of non-steroidal anti-inflammatory drugs, are the basis of non-surgical treatment. However, surgical treatment is often necessary to allow a return to activities, and the options are surgical dislocation of the hip, hip arthroscopy, periacetabular and rotational osteotomies, and the combination of arthroscopy with a limited open technique. Although the literature abounds in medium-term results supporting surgical treatment, there are at present no long-term prospective studies, or natural-history studies, examining the consequences of femoroacetabular impingement (FAI) and the effect of early surgical intervention.