The diagnosis and management of femoro-acetabular impingement.
BACKGROUND
Femoro-acetabular impingement (FAI) was first described in 1999 as abnormal abutment between the acetabulum and the femoral head and neck. Since then, it has been shown to be responsible for many acetabular labral tears and is implicated in the aetiology of osteoarthritis of the hip. This review introduces the concept of FAI and reports the key aspects of its diagnosis and management.


METHODS
A comprehensive search of the literature was conducted using the Pubmed database. Articles relating to the aetiology, pathophysiology, clinical features, diagnosis and treatment of FAI were reviewed. Search terms included femoro-acetabular impingement, arthroscopic treatment, open treatment, aetiology, pathophysiology. The search was limited to articles published in English. All articles were read in full by the authors and selected for inclusion based on relevance to the article.


RESULTS
An increasing number of studies relating to FAI have been produced in the 10 years since its recognition. A range of clinical and radiological features have been described. Surgical management can be performed using a number of techniques, with promising results from various studies. Early treatment with open surgery has paved the way for less invasive and arthroscopic approaches, with short-to-medium term data demonstrating favourable functional results for arthroscopic treatment of FAI.


CONCLUSIONS
A greater awareness of the diagnostic features of FAI, and the various management options available, will allow timely diagnosis and treatment of a relatively newly recognised syndrome. Early treatment may then help to prevent progression to end-stage osteoarthritis of the hip.
Macfarlane
Robert J
RJ
Department of Trauma and Orthopaedics, University College Hospital, London, UK. robert.macfarlane@doctors.org.uk
Haddad
Fares S
FS
D000077:Acetabulum / Q000473:pathology / Q000601:surgery; D005270:Femur Head / Q000473:pathology / Q000601:surgery; D005272:Femur Neck / Q000473:pathology / Q000601:surgery; D006621:Hip Joint / Q000473:pathology* / Q000601:surgery; D006801:Humans; D016916:Joint Deformities, Acquired / Q000175:diagnosis* / Q000601:surgery; D008279:Magnetic Resonance Imaging