Impingement (FAI)

Question 1

What is FAI?

Answer 1

Femoroacetabular Impingement is premature contact (pinching) of the proximal femur with the acetabulum.

Question 2

What are the different morphologies (types) of FAI?

Answer 2

• Cam
• Pincer
• Cam & Pincer

Question 3

Give me some understanding of how prevalent FAI is in the general population:

Answer 3

Present in ~30% of the population (although like most morphologies many do not show symptoms)

Question 4

What is the Cam Morphology?
+ whom does it most commonly affect?

Answer 4

A flattened or convex femoral head-neck junction.
Most common in young, athletic men.

Question 5

Given that Cam, Pincer and combinative morphology can be present without symptoms, what other factors may be involved with symptomatic individuals?

Answer 5

• Weakness around hip stabilisers.
• Repeated labral loading.

Question 6

What is the Cam & Pincer Morphology?

Answer 6

A combination of both:
Cam = flattened femoral head-neck
Pincer = extended acetabular rim

Question 7

What are the symptoms of FAI?

Answer 7

• Moderate hip/groin pain
• Thigh, Back or Buttock Pain
• Stiffness & Dec. ROM
• Clicking and/or Catching
• Locking or Giving Way

Question 8

What is the aetiology (cause) of FAI?

Answer 8

Multifactorial and not well understood.
- Morphology.
- Repetitive hip rotation and flexion in childhood.
- Malunion post-#NOF.
- Childood hip diseases (SCFE or Legge-Calve-Perthes).

Question 9

What is the Pincer Morphology?
+ whom does it most commonly affect?

Answer 9

‘Overcoverage’ of the femoral head by an extended acetabular rim.
More common in women.

Question 10

What special tests can be used to diagnose FAI?

Answer 10

Hip Inpingement Tests:
FADIR
FABER
McCarthys

Question 11

What is the Prognosis for FAI?

Answer 11

Without management or treatment it will deteriorate and lead to OA.
It is possible to fully recover and manage episodes conservatively.

Question 12

Describe conservative management for FAI:

Answer 12

Strengthening Hip ER, Abd & Flexors
Core Stability
Postural Balance Exercises
Hydrotherapy

Question 12

What exercises are good for FAI, and what are bad?

Answer 12

Good:
- HF, Piriformis & groin stretching
Strengthening = bridge, lateral band walk, hip thrust, pelvic tilts
Bad:
- Knee moves above hip e.g. deep squat, lunge, deep leg press, deadlift

Question 13

What is the Lateral Centre-Edge Angle (LCEA)?

Answer 13

A radiological measurement of the bony coverage of the acetabulum over the femoral head for assessment of Pincer Morphology.

Question 14

What is the main treatment for FAI?

Answer 14

There is currently no high-level evidence to support the choice of a definitive treatment for FAI syndrome.

Question 15

What is the Alpha Angle?

Answer 15

A radiological measurement for the evaluation of a Cam Morphology.