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Femoroacetabular Impingement (FAI)

Femoroacetabular impingement (FAI) is a condition in which extra bone grows along one or both of the bones that form the hip joint — giving the bones an irregular shape. Because they do not fit together perfectly, the bones rub against each other during movement.

A common cause of

  • Early onset hip dysfunction
  • Secondary osteoarthritis
PRESENTATION
Symptoms
  • Activity related groin or hip pain, exacerbated by hip flexion
  • Difficulty sitting
  • Mechanical hip symptoms
  • Can present with gluteal or trochanteric pain
  • Due to aberrant gait mechanics
Imaging

Radiographs to assess anterior coverage of the femoral head

CT can be used as adjunct to assess for structural abnormalities

MRI best modality to evaluate for articular cartilage, and labral degeneration and tears can assess anatomy of femoral head/neck junction abnormalities

Treatment

Nonoperative

Observation
  • Indications
  • Minimally symptomatic patient
  • No mechanical symptoms
  • Operative
Arthroscopic hip surgery
  • Indications
  • Symptomatic patient
  • Mechanical symptoms
Total hip arthroplasty
  • Indications
  • Age >60 years and end-stage hip degeneration
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