7 things you need to know about Femoroacetabluar Impingement (FAI)

 In Lower Limb

Femoroacetabluar Impingement (FAI)

  1. Femoroacetabular Impingement (FAI) is a condition in the hip which involves too much bone growing in the area of the ball and socket joint causing a rubbing or jamming effect.
  2. There are 3 types of FAI
    a.  Cam Lesion: where there is too much bone on the femoral neck (the ball side) causing a bump to jam on the acetabulum (the socket side).
    b.  Pincer Lesion: too much bone on the edge of the acetabulum (the socket side) causing a lip to jam on the femoral neck (the ball side).
    c.  Mixed Lesion: a combination of both
  3. FAI most commonly affects young athletic males with a cam lesion being most common and middle age women with a pincer lesion being most common. It is most prevalent in people participating in activities which require a great deal of hip flexion or twisting of the legs such as: AFL, surfing, soccer, rugby, hockey, cycling, waterpolo, martial arts, golf, rowing, ballet/dancing.
  4. They still don’t know what causes it. Experts are not sure whether it is something that is present from birth or whether it is something that develops as your skeleton grows. It is most likely a combination of ones genetics and environmental factors such as activities during growth
  5. It is most commonly diagnosed with a combination of patient history, physical exam and pain film X-Rays.
  6. Symptoms of FAI can come on after a specific trauma to the area, or it can have an insidious onset (no cause). The most common symptoms of FAI that people complain of include: restriction in hip range (particularly internal rotation and flexion), a jam or catch with hip flexion, an ache deep in the hip joint, difficulty sitting or standing for long periods, pain in and around the low back region
  7. FAI can be treated both conservatively with physio via the use of manual therapy and a combination of anti-inflammatories and painkillers as required
    Conservative management aims to:
    Stretch out the tight structures surrounding the hip.
    • Strengthen the hip stabilizers protecting the hip joint.
    • Improve the flexibility of the muscles and soft tissue around the joint.
    • Improve the stability and control around the hip.
  8. However if conservative management fails a hip arthroscopy may be required to file down the extra bone (cam or pincer lesion) in the hip to stop the impingement from occurring. This is performed by an orthopaedic surgeon and is usually done via keyhole surgery.

By Kevin Laidlow (APAM)

POGO Master

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