FAI

FAI can result from structural abnormalities in the hip joint that lead to abnormal contact between the femoral head and acetabulum. These abnormalities may include:

1. Cam Impingement: A bony prominence on the femoral head, typically at the junction between the head and neck of the femur, causing abnormal contact with the acetabulum during hip motion.
2. Pincer Impingement: Excessive coverage of the femoral head by the acetabulum, often due to an overgrown or deepened acetabular socket, leading to impingement with the femoral neck.
3. Combined Impingement: A combination of cam and pincer impingement, where both the femoral head and acetabulum contribute to abnormal contact and impingement in the hip joint.

1. Hip Pain: Patients with FAI often experience hip pain, typically located in the groin area, that worsens with certain activities, such as walking, running, or prolonged sitting.
2. Decreased Range of Motion: Restricted range of motion in the hip joint, particularly with activities that require flexion, internal rotation, or adduction of the hip.
3. Stiffness: Stiffness or tightness in the hip joint, especially after periods of inactivity or prolonged sitting, is common in individuals with FAI.
4. Clicking or Catching Sensations: Some patients may report clicking, catching, or locking sensations in the hip joint during movement, indicating possible impingement and labral irritation.

Diagnosing FAI typically involves a combination of clinical evaluation and imaging studies, including:

• Physical Examination: Assessment of hip range of motion, strength, and provocative tests to reproduce symptoms, such as the impingement test or FADIR (flexion, adduction, and internal rotation) test.
• Imaging Studies: X-rays, MRI scans, or CT scans may be ordered to visualize the bony anatomy of the hip joint, assess for structural abnormalities, and identify any associated labral or cartilage damage.

Conservative Management:

• Activity Modification: Avoiding activities that exacerbate hip pain and impingement, such as high-impact sports or activities that require deep hip flexion.
• Physical Therapy: Strengthening exercises, stretching, and manual therapy to improve hip stability, mobility, and biomechanics.
• Pain Management: Non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroid injections, or hip joint injections may help alleviate pain and inflammation.

Surgical Intervention:

• Arthroscopic Hip Surgery: Minimally invasive procedure to address structural abnormalities and intra-articular pathology associated with FAI, such as cam or pincer resection, labral repair or debridement, and cartilage preservation techniques.
• Open Hip Surgery: In some cases of complex FAI or severe deformities, open surgical techniques may be necessary to address bony abnormalities, such as femoral or acetabular osteotomies, to restore normal hip mechanics.

Recovery from FAI surgery depends on the extent of the procedure, individual patient factors, and adherence to postoperative rehabilitation protocols. Physical therapy plays a crucial role in restoring hip strength, range of motion, and proprioception, while protecting healing tissues and optimizing functional outcomes. Rehabilitation typically involves a gradual progression of exercises focused on hip stability, mobility, and strength, with the goal of achieving a safe return to activities and sports participation.