Femoroacetabular Impingement
How does the femoro-acetabular conflict arise?
The femoro-acetabular or FAI (Femoro-Acetabular Impingement) conflict is the pathology that affects the hip due to the malformation of the joint joints that, instead of flowing in harmony, collide with each other.
How and why does it develop?
In most cases the femoro-acetabular conflict develops at an early age as a structural alteration of the hip. Because of this alteration the bone of the femur appears to have a limited range of action and has no other way but to bump the edges of the acetabulum to move. There are two types of femoral-acetabular conflict:
The "pincer" conflict (FAI pincer), where the acetabulum is too tight on the femoral head
The "cam" (cam FAI) conflict, in which the problem is due to the deformation of the femoral head, which is not perfectly round and hits the acetabulum.
What in healthy subjects would occur only in cases of particularly unusual and reckless acts, in sick patients is habitual.
The most affected subjects are the young physically active, mostly the athletes, where the protracted effort to which the joint is subjected makes evident the effects of the disorder, which would remain hidden in the absence of such repetitive gestures.
What are the symptoms?
The pain associated with the femoro-acetabular conflict usually arises as a result of excessive stress during a sport activity and manifests itself as a pain not better identified by the patient between the groin and the buttock, often passing. Initially, the pain occurs only during specific movements in which a curvature of the hip occurs (eg, when the legs are crossed), but then becomes so unbearable as to oblige the suspension of any sporting activity. In the most acute phase the patient experiences pain even in the simple act of walking and unwittingly begins to take shorter steps, bringing the anterior part of the foot outwardly, in an unnatural way. If not treated immediately, the patient will no longer be able to regain normal walking.
What are the treatments for the femoro-acetabular conflict?
The femoro-acetabular conflict, if diagnosed late, necessarily requires the implantation of a hip replacement. When it is diagnosed in time, the disease can be treated through an arthroscopy surgery in which the agents responsible for the conflict are surgically modified. Finally, if the patient does not want to intervene surgically, the only solution is an anti-inflammatory therapy in a cyclic and chronic form or the infiltration of hyaluronic acid. This treatment obviously does not guarantee the final resolution of the problem and simply has a palliative effect.