Femoroacetabular impingement, also known as FAI, is a common cause of hip pain. The hip joint is a ball and socket joint. In FAI, an abnormal shape of either the socket and/or ball can result in abnormal contact between the two. This can result in cartilage damage and injury to the surrounding soft tissue structure called the labrum, which causes pain and dysfunction.
Here are 5 things you should know about FAI:
1. If you have FAI, you may experience a loss of range of motion, making it difficult to properly perform activities that would otherwise be painless. Examples include jumping, running, sitting in a bar chair or sitting for long periods of time. Typically, pain will be located in the groin area or a letter “C” distribution.
2. Before rushing to surgery, there are a number of options for treating FAI conservatively. Physical therapy can improve symptoms in over 50% of patients. Injections such as corticosteroids, platelet-rich plasma (PRP) and stem cells may also improve symptoms and perhaps delay or prevent the need for surgery.
3. When conservative measures fail, minimally invasive hip arthroscopy is an excellent option for addressing the problem. This surgery is done through small key-hole incisions and a special camera to view inside the hip and reshape the bones to fit together better, as well as to repair any soft tissue damage such as a labral tear. This procedure is successful in up to 93% of patients, however it is important you find a physician that is fellowship trained in this procedure.
4. Some patients have too much “twisting” of their bones called torsion or an abnormally shaped socket (dysplasia) that requires a more invasive procedure where the bones are cut and re-aligned. A hip arthroscopy alone in these situations can lead to adverse outcomes. Appropriate x-rays and advanced imaging studies by your orthopedic surgeon will help determine if you are a good candidate for hip arthroscopy.
5. Unfortunately, some patients are also not good candidates for a hip arthroscopy due to too much wear and tear of the cartilage that lines the joint, resulting in arthritis. Studies have shown that patients with significant arthritis who undergo a hip arthroscopy will require a hip replacement within 5-years; a hip replacement is the better option for these patients. Newer designs and techniques have resulted in better outcomes and durability of the implants.