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The management of symptomatic femoroacetabular impingement: what is the rationale for non-surgical treatment?
  1. Nicola C Casartelli1,
  2. Nicola A Maffiuletti1,
  3. Mario Bizzini1,
  4. Bryan T Kelly2,
  5. Florian D Naal3,
  6. Michael Leunig3
  1. 1Human Performance Lab, Schulthess Clinic, Zurich, Switzerland
  2. 2Center for Hip Preservation, Hospital for Special Surgery, New York, New York, USA
  3. 3Department of Orthopaedic Surgery, Schulthess Clinic, Zurich, Switzerland
  1. Correspondence to Dr Nicola C Casartelli, Human Performance Lab, Schulthess Clinic, Lengghalde 2, Zurich 8008, Switzerland; nicola.casartelli{at}kws.ch

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Introduction

Femoroacetabular impingement (FAI) is a pathomechanical process often associated with bony deformities at the proximal femur and/or acetabulum in conjunction with repetitive, rigorous or supraphysiological hip motion.1 It may cause acetabular labral injuries and hip pain, and can lead to developing early hip osteoarthritis.1 Since FAI is thought to be caused primarily by structural hip abnormalities, surgery—whether open or arthroscopic—is considered to be the main treatment.1 Nevertheless, dynamic hip joint instability, defined as excessive femoral head translation relative to the acetabulum during daily and sports activities,2 may also contribute to the FAI pathomechanism. Indeed, this may lead to mechanical overloading of the hip joint structures and pain.3 Managing dynamic hip joint instability has often been overlooked in terms of treatment options for FAI. This editorial proposes a rationale, discussing the potential effectiveness, for non-surgical intervention to improve dynamic hip joint stability and reduce hip pain in patients with symptomatic FAI.

FAI-related osseous and inert hip abnormalities

Hip …

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