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Femoroacetabular impingement: prevention or intervention? The sports physician's quandary
  1. J Cakic1,
  2. J Patricios2,3,4
  1. 1The Centre for Sports Medicine and Orthopaedics, Johannesburg, South Africa
  2. 2Morningside Sports Medicine, Johannesburg, South Africa
  3. 3Section of Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
  4. 4Department of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
  1. Correspondence to Dr Jon Patricios, PO Box 1267, Parklands 2121, South Africa; jpat{at}mweb.co.za

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The condition

Femoroacetabular impingement (FAI) is a mechanical process by which the human hip fails due to pathological contact between the skeletal prominences of the acetabulum and the femur. This repetitive pathological contact occurs during normal activities of daily living as well as, more prominently, in an athletic population. This causes a microtraumatic effect and subsequently irreversible chondral damage to the acetabular as well as femoral surfaces—osteoarthritis of the hip joint.1

Two types of impingement are identified: the first, pincer impingement, is due to an acetabular abnormality and results in over coverage of the femoral head. The second type, Cam impingement, results in femoral morphological change and alteration of the spherical portion at the head/neck junction of the femur. The majority of patients have a mixed picture, with features of Cam and pincer type of impingement.2

As Dr Thomas Byrd mentioned in his recent current concept3: ‘The implication of abnormal hip morphology leading to secondary joint damage had been variously described for almost a 100 years.’ However, the concept of FAI as a cause of osteoarthritis is credited more recently to Ganz et al.1

Occult symptoms…

Typically, …

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