Femoroacetabular Impingement: A Common Cause of Hip Pain in Young Adults

Objective: Femoroacetabular impingement (FAI) is a common cause of hip discomfort in young adults. Recently, a better understanding of the pathomechanics and morphologic abnormalities in the hip has implicated FAI as a possible factor in early osteoarthrosis. The clinical presentation, physical examination findings, and radiographic features are discussed in this article. Data Sources: PubMed was searched using words and terms including femoacetabular impingement, hip osteoarthritis, hip arthroscopy, early osteoarthrosis, and hip dislocation. References of relevant studies were searched by hand. Study Selection: All studies directly involving the treatment of FAI were reviewed by 3 authors and selected for further analysis, including expert opinion and review articles. Data Synthesis: The quality of each study was assessed, and the results were summarized. Conclusions: Conservative measures, including physical therapy, restriction of activities, core strengthening, improvement of sensory-motor, and control and nonsteroidal anti-inflammatories are the mainstays of nonsurgical treatment. However, surgical management is often necessary to allow full return to activity with options including surgical dislocation of the hip, hip arthroscopy, periacetabular and rotational osteotomies, and combined hip arthroscopy with a limited open exposure. Although the literature is replete with short-term evidence to support surgical treatment, there are currently no long-term prospective data or natural history studies examining the implications of FAI and effects of early intervention.