Femoroacetabular Impingement in the Adolescent Athlete

Abstract

Femoroacetabular impingement syndrome (FAIS) is a source of hip pain that can present in adolescent athletes and is related to sports participation and extreme use in these patients. FAIS is characterized by morphologic abnormalities of the acetabulum and/or proximal femur that leads to pathologic contact within the hip joint. FAIS is classified as cam-type, pincer-type, or combined. Early sports participation is a factor in the development of symptomatic FAIS. Adolescent patients with FAIS are also more likely to have associated extra-articular pathologies. History and physical exam findings in adolescents with FAIS are not considerably different than corresponding findings in adults with FAIS and include activity-related groin pain aggravated by pivoting and flexion activities. FAIS can be treated conservatively or surgically. In refractory cases, outcomes after surgical intervention have been shown to be significantly better than nonsurgical treatment. Surgical intervention involves repairing damage to the labrum and/or cartilage and decompressing the bony impingement. Open and arthroscopic approaches have been shown to be safe and effective in adolescents with good outcomes. Most adolescent athletes are able to return to participation in their sport and a majority returning to their preinjury level of play after surgical intervention.