Femoroacetabular Impingement
What is Femoroacetabular Impingement Arthritis?
Femoroacetabular impingement (FAI) is a condition where abnormal contact occurs between the femoral head/neck junction and the acetabular rim during hip movement. Over time, this repetitive abnormal contact can damage the labrum (the cartilage rim around the socket) and the articular cartilage, and is recognised as an important cause of early hip pain and osteoarthritis in young, active adults.
Three patterns of impingement are described:
• Cam type: an extra bump on the femoral head-neck junction causes the femur to jam into the socket with hip flexion and rotation.
• Pincer type: over-coverage of the femoral head by the acetabulum (socket) causes pinching of the labrum against the femoral neck.
• Mixed type: a combination of cam and pincer deformities, which is the most common pattern.
Symptoms of Femoroacetabular Impingement
Patients with FAI may experience:
Treatment options
Non-surgical treatment: activity modification, physiotherapy focused on core stability and hip muscle strengthening, anti-inflammatory medications and image-guided intra-articular injections may be enough to control symptoms in many patients.
Surgery: in patients with persistent symptoms despite non-operative treatment, and in the absence of advanced arthritis, surgical management is considered. This may include hip arthroscopy or open surgery to reshape the femoral head-neck junction (osteochondroplasty), trim the acetabular rim and repair the labrum. In selected cases with underlying structural abnormalities, periacetabular osteotomy or femoral osteotomy may be indicated.
Frequently Asked Questions (FAQ)
Hip arthritis usually develops over time rather than from a single cause. The most common reason is gradual wear of the joint cartilage with age. However, many people develop it earlier due to subtle issues with the shape of the hip, when the ball and socket don’t fit perfectly, it creates uneven pressure that slowly damages the joint. Previous injuries, such as fractures or dislocations, can also speed up this process. In some cases, genetics, inflammation, or increased load on the joint (including higher body weight or repetitive stress) contribute.
