Editorial - Journal of Physical Therapy and Sports Medicine (2021) Volume 5, Issue 6
Femoroacetabular impingement syndrome
Department of Sports Medicine
E-mail: [email protected]
Accepted on November 11, 2021
FAI is a condition in which excess bone grows along one or both of the bones that make up the hip joint, causing the bones to become irregularly shaped. The bones grind against one other during movement because they don't fit together completely. This friction can wear down the joint over time, producing pain and limiting activity. A ball-and-socket joint, the hip is a balland-socket joint. The acetabulum, which is a portion of the big pelvis bone, forms the socket. The femoral head, or top end of the femur, is the ball (thighbone).The surface of the ball and socket is covered in a slippery tissue called articular cartilage. It generates a smooth, low-friction surface that allows the bones to slide freely across each other.
The labrum is a strong fibrocartilage ring that surrounds the acetabulum. The labrum creates a gasket around the socket, forming a tight seal and assisting in joint stability. Bone spurs form around the femoral head and/or along the acetabulum in those who have FAI. This extra bone generates improper contact between the hip bones, making it difficult for them to move freely during movement. Over time, this can result in labrum tears and articular cartilage breakdown (osteoarthritis)
FAI can be classified into three types: pincer, cam, and mixed impingement:
Pincer: This sort of impingement happens when excess bone spreads beyond the acetabulum's natural rim. The labrum can be crushed beneath the acetabulum's broad rim.
Cam: The femoral head is not spherical in cam impingement, and it cannot rotate smoothly inside the acetabulum. On the edge of the femoral head, a bump forms, grinding the cartilage inside the acetabulum.
Combined: Both the pincer and cam forms of impingement are present in combined impingement.
FAI develops when the hip bones do not form properly during childhood growth. Joint injury and pain are caused by the deformity of a cam bone spur, pincer bone spur, or both. There is little that can be done to avoid FAI when the hip bones are formed incorrectly. The exact number of persons who have FAI is unknown. Some persons with FAI may live long, busy lives with no difficulties. When symptoms appear, however, it usually means that the cartilage or labrum has been damaged, and the condition is likely to progress. Athletic folks may suffer pain sooner than those who are less active because they work the hip joint more forcefully. Exercise, on the other hand, has no such effect.
The 2% of participants in their prospective longitudinal cohort study had mixed morphology, an estimated 85 percent of patients with FAI have mixed morphology, which means they have both cam and pincer morphologies (albeit in a primarily middleaged population).It's worth noting that these morphologies are estimated to be fairly widespread (about 30% of the general population), even in those who don't have hip pain. As a result, the presence of either cam or pincer morphology on its own is insufficient to diagnose FAI syndrome. Due to impingement between the acetabular rim and the femoral head during movement, both types of morphology can cause injury to the articular cartilage and labrum, resulting in FAI syndrome symptoms.
Arthroscopic surgery can help with a lot of FAI issues. Small incisions and thin devices are used in arthroscopic treatments. The surgeon examines the inside of the hip with an arthroscope, a tiny camera. Your doctor can repair or clean up any damage to the labrum and articular cartilage during arthroscopy. By reducing the bony rim of the acetabulum and shaving down the hump on the femoral head, he or she can treat the FAI. Impingement symptoms can be successfully reduced with surgery. The impingement can be removed, preventing further injury to the hip joint. However, surgery will not be able to repair all of the damage, especially if therapy has been delayed and the damage is severe. It's probable that more issues will arise in the future.
As surgical outcomes improve, doctors will likely offer FAI surgery earlier. Surgical procedures are improving, and computers may one day be utilised to assist surgeons in repairing and modifying the hip. Patients with symptomatic FAI syndrome who are treated report that their symptoms have improved and that they are able to resume their normal activities. However, neither the long-term prognosis nor if treatment of FAI syndrome reduces the development of hip OA are known.