What is FAI and how does it cause hip pain?

Femoroacetabular impingement (FAI) is a condition that affects the hip joint, primarily involving abnormal contact between the femoral head (the ball-shaped end of the thigh bone) and the acetabulum (the hip socket).

This mechanical conflict can lead to pain, limited range of motion, and cartilage damage within the hip joint. FAI is generally thought to be a precursor to osteoarthritis. Understanding the anatomy, types, causes, diagnosis, and treatment options for FAI is crucial for effective management of this condition.

Anatomy of the Hip Joint:

The hip joint is a ball-and-socket joint formed by the femoral head and the acetabulum. It allows for a wide range of motion and bears significant weight and stress during various activities.

The joint is surrounded by a strong capsule and supported by ligaments, muscles, and a layer of articular cartilage that covers the surfaces of the bones, facilitating smooth movement.

Types of Femoroacetabular Impingement:

FAI is categorised into three main types: cam impingement, pincer impingement, and combined impingement.

  1. Cam Impingement: In cam-type FAI, there is an abnormal bony growth on the femoral head or neck, causing a non-spherical shape. This can lead to increased friction and impingement within the hip joint during certain movements.
  2. Pincer Impingement: Pincer-type FAI involves excessive coverage of the femoral head by the acetabulum (socket), often due to an overgrown rim. This can lead to impingement when the hip is flexed or rotated.
  3. Combined Impingement: Combined impingement involves a combination of both cam and pincer types, where both the femoral head and acetabulum contribute to the impingement.

Causes of Femoroacetabular Impingement:

The exact cause of FAI is not always clear, but several factors contribute to its development. These include genetic predisposition, abnormal hip joint development during adolescence, and repetitive activities that stress the hip joint, such as certain sports or occupations that involve repeated hip flexion.

Symptoms and Diagnosis:

Patients with FAI may experience pain or pinching in the high groin region, especially during activities that involve flexion, rotation, or prolonged periods of sitting. The pain is often located in the groin region but can also radiate to the buttocks or thigh.

Diagnosis typically involves a thorough clinical examination, imaging studies like X-rays and magnetic resonance imaging (MRI), and sometimes additional diagnostic injections to confirm the source of pain.

Treatment Options:

The management of FAI involves both conservative and surgical approaches, depending on the severity of symptoms and the extent of joint damage.

  1. Conservative Treatment: This includes lifestyle modifications, physiotherapy to improve hip and trunk strength and flexibility, and occasionally non-steroidal anti-inflammatory drugs (NSAIDs) to manage pain and inflammation.
  • Surgical Intervention: For cases that do not respond to conservative measures, surgical options may, in rare occasions, be considered. Arthroscopic surgery may address FAI. During this procedure, the surgeon can reshape the bone to eliminate impingement, repair damaged cartilage, and address other intra-articular issues.

Rehabilitation and Prognosis:

Postoperative rehabilitation is a crucial aspect of FAI management. Physiotherapy helps restore strength, flexibility, and joint function. Patients usually experience a gradual return to activities, with a focus on avoiding movements that may contribute to impingement.

Conclusion:

Femoroacetabular impingement is a complex hip joint disorder that can significantly impact an individual’s quality of life. Understanding the anatomy, types, causes, and treatment options for FAI is essential for accurate diagnosis and effective management.

Both conservative and surgical approaches may address this condition, and a multidisciplinary approach involving orthopaedic surgeons, physiotherapists, and other healthcare professionals may be necessary for optimal patient outcomes.

At Destiny Health, we offer a Free Assessment for all musculoskeletal aches and pains. Just like getting a quote from your local tradesperson, we feel that’s only fair before you commit to a treatment plan.

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