Femoro-Acetabular Impingement (FAI)
Background: Hip is a ball and socket type joint. When the ball (femur head) or the socket (acetabulum) becomes slightly abnormal in shape due to developmental reasons the smooth gliding of the joint is affected. This damages the labrum a cartilage that runs along the rim of the socket and leads to early wear of joint cartilage. This may result in early onset hip arthritis in some patients.
Presentation: Pain is the main symptom. Commonly starts spontaneously. Sometimes an injury precipitates pain and is felt in the groin and front of the hip. Clicking sensation can be felt. Spasms and giving way sensation due to pain can be present.
Diagnosis: This condition is common in younger patients. Clinical examination and plain radiograph often confirms the diagnosis. Occasionally CT scan is necessary to confirm the diagnosis. MRI scan helps to confirm the diagnosis, assess cartilage and other soft tissue around the hip.
Nonoperative treatment: Physiotherapy sometimes to helps to ease the pain. Strengthening and stretching muscles around the hip, improving spine-pelvic position and modification physical activities might ease the pain. Often pain from FAI is resistant to these measures or can recur easily.
Operative treatment: If pain is a major problem and restricts physical activity inspite of adequate physiotherapy directed exercises then surgery can be considered. Surgery usually involves addressing the bony impingement lesion both on the socket and ball of the joint, and repairing the labrum cartilage with sutures. It is done almost always arthroscopically now a days.