it is a relatively new concept and has been receiving increased attention especially in recent years due to its close relationship with labral injuries, chondral damage and degenerative arthritis. It is one of the important causes of hip pain, especially in young adults.
Etyopathogenesis:In the presence of FAI, abnormal contact is observed between the femur head-neck and the acetabuler ring, especially towards the end of the flexion, in the movement of the hip joint. In FAI cases, it has identified two basic mechanisms that can cause hip pain or labral pathologies. Type 1 is cam impingement (femoral type) deformity and Type 2, pincer impingement (acetabuler type). These two different mechanisms can be seen together in many cases. In this case, the concept of mixt type impingement is used.
Diagnose: Fai is most often in the form of anterior femur neck and anterosuperior acetabular impingement, where cam and pincer impingement are together. in the presence of cam impingement, the protrusion in the femur head-neck joint with full flexion causes recurrent stress forces in the anterosuperior acetabulum and ultimately creates labral injuries in this region with acetabular condral dissociation. In pincer impingement cases, as a result of repeated abnormal contacts of the femur neck and acetabular ring, chondral damage occurs in the posteromedial part of the femur head and posteroinferior part of the acetabulum. As a result, depending on the pain, the daily activities of the patient are restricted.
Treatment: The place of conservative approach is quite limited. It may be recommended to avoid activities that will bring the motion clearness of the relevant extremity to extremes. Non-steroidal anti-inflammatory drugs can be given in painful situations. Its usefulness is limited, since the application of physical therapy will not prevent the underlying pathology.. In surgical treatment, open or arthroscopic surgery can be applied. The main advantage of open surgery; limited in incision but it is almost completely visible to the joint and as a result, joint debridement ,labral debridement or repair, femoral osteoplasty and acetabuler osteotomy can be easily performed. In arthroscopic surgery, although the joint cannot be dominated that much, many of the complications that open surgery can bring with it are not encountered. Since it is a minimal surgery, patient comfort is much better.
