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Striving for multidisciplinary consensus on the diagnosis and management of patients with femoroacetabular impingement: more evidence is needed
  1. David J Hunter1,2,
  2. Oliver Marín-Peña3
  1. 1 Institute of Bone and Joint Research, The Kolling Institute, The University of Sydney, Sydney, New South Wales, Australia
  2. 2 Rheumatology Department, Royal North Shore Hospital, Sydney, New South Wales, Australia
  3. 3 Orthopaedic Surgery and Traumatology Department, University Hospital Infanta Leonor, Madrid, Spain
  1. Correspondence to Dr David J Hunter, Rheumatology Department, Royal North Shore Hospital, Pacific Highway, Sydney, NSW 2065, Australia; david.hunter{at}

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In recent years, abnormal hip joint morphology has emerged as a significant factor responsible for the onset of hip osteoarthritis (OA). This is believed to lead to pathological loading patterns that produce shear stresses on the hip joint over time.1 Ganz et al 2 described two different morphological patterns of femoroacetabular impingement (FAI): cam and pincer FAI.

What is the prevalence of FAI morphology in the general population? Estimates vary wildly owing to disparity in the definition of FAI morphology used and in the populations sampled. The proportion of the population with symptoms related to FAI is only a fraction of those with FAI morphology. Furthermore, the presence of severe morphological abnormalities does not always bring about hip OA, suggesting that there are other factors at play in hip OA pathogenesis than just joint morphology.

The need for consensus

This recently defined clinical problem of FAI with widely disparate definitions available and controversy about management motivated the need for some consensus. This international consensus (see page 1169) provides a broad overview of important questions in this challenging field …

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  • Twitter Follow Oliver Marín-Peña @olivermarinpena, David Hunter @ProfDavidHunter

  • Contributors DJH researched data for the article. DJH and OM-P contributed to discussion of content, writing the article and reviewing and editing the manuscript before submission.

  • Funding DJH is supported by a National Health and Medical Research Council (NHMRC) Practitioner Fellowship.

  • Competing interests DJH is a consultant to Flexion, Nestle and Merck Serono.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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