The Management of Femoroacetabular Impingement

Abstract

Management of the Femoroacetabular Impingement (FAI) starts with good diagnosis. What one must remember that the natural course of FAI is the precursor to hip osteoarthritis. An excellent history taking and physical examination is mandatory to exclude many differential diagnosis surrounding the hip. A layered approach could be used. 90 degrees of flexion and internal rotation (FADIR) is specific for hip problem, although doesn’t mean the main culprit is always FAI. Radiology study is very important, several hip projection Xray that can be chosen and specific measurement like Alpha angle, Cam or Pincer or mixed deformity, and so on. Additional imaging with CT or MR Arthrography is also important. With confirmed FAI, controversies exist whether to proceed conservatively or surgery, with nuance of the evidence depends on the background of the writer. Nowadays, surgery for FAI already pushed toward full arthroscopic, while surgical hip dislocation remains a powerful arsenal. Rehabilitation after surgery is utmost importance, and it took time for the results to show it benefits, therefore, a good communication with patient and the whole team of care is advisable.