Dr. Sucato explains the two types of FAI.

Mar 29, 2018 / Hip Disorders

#SRHaccess Facebook LIVE Recap: Femoroacetabular Impingement

On this week’s Facebook live, Chief of Staff Daniel J. Sucato, M.D., M.S. joined us to discuss femoroacetabular impingement, also known as FAI. Below is a recap of the conversation.

Watch the segment. 

What is femoroacetabular impingement (FAI)?
  • The femur bone normally has a nice range of motion to internally and externally rotate.
  • FAI occurs when the femur, as it flexes, impinges against the socket causing pain.
  • Our specialists are seeing more and more patients who are active earlier on in life in a profound and consistent way.
  • FAI normally occurs from an overuse injury during a certain activity or sport. 
What is the average age range FAI is being diagnosed?
As young as nine years old all the way into early adulthood. 

Two types of FAI:
  • Cam impingement: primary problem is on the ball part of the hip. A little bump on the ball of the hip develops and when in flexion, hits up against the socket causing pain. The injury occurs to the socket cartilage at first. 
  • Pincer impingement: primary problem is on the socket side. There is too much overhang from the socket causing the pain. The injury occurs on the labrum at first. 
  • It is possible for an adolescent to have both types of FAI at once. 
Where is the pain located?
  • Groin pain – pain at the front of the hip.
  • Hip pain to the side is more muscle. 
  • At the beginning, pain is associated with FAI occurs during activities or sport.
  • As it progresses, it could be painful to walk.
Potential hip conditions that lead/cause FAI later in adolescence:
  • Perthes disease – ball part of the hip takes on a bigger shape and could create a cam impingement. 
  • Slipped Capital Femoral Epiphysis (SCFE) – ball part of the hip slips out of place.
  • FAI could be associated with a previous pediatric hip condition, however that is not always the case. 
  • Idiopathic FAI: otherwise healthy hip, but the condition develops over time with no cause.
Are there certain sports or activities that cause FAI?
  • Depending on how active or position the patient plays, sports/activities where there is consistent hip flexion past 90 degrees.
  • Figure skating, gymnastics, dancing, track
What can parents/patients expect when they come to Scottish Rite Hospital? 
  • Team approach to care: patients will be seen by several members of the health care team. 
    • Psychologists: understand the patient’s pain, understanding where the pain is generating from and if there are other factors causing the pain. 
    • Movement Science Lab: study the patient’s hip motion. 
    • Nursing staff, physical therapy and orthopedic doctor will see the patient. 
  • Advanced imaging – state-of-the art MRI. 
Treatment options:
  • Physical therapy: stabilize the hip through strengthening and stretching.
    • PT program specific to the patient’s needs and symptoms.
  • Surgical treatment is determined depending on the patient and severity of their condition.
  • Every adolescent hip patient gets enrolled in the Global Hip Study. 
  • The patient is asked specific patient related quality of life questions, which are answered on a tablet.
  • Studies are conducted in the movement science lab to objectively measure range of motion, strength and gait. 
  • The purpose of this study is to demonstrate the differences in patients before and after treatment – what was successful versus what was not. 
Learn more about the research in the Center for Excellence in Hip. 

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