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The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement
  1. D R Griffin1,2,
  2. E J Dickenson1,2,
  3. J O'Donnell3,4,
  4. R Agricola5,
  5. T Awan6,
  6. M Beck7,
  7. J C Clohisy8,
  8. H P Dijkstra9,
  9. E Falvey10,11,
  10. M Gimpel12,
  11. R S Hinman13,
  12. P Hölmich9,14,
  13. A Kassarjian15,16,
  14. H D Martin17,
  15. R Martin18,19,
  16. R C Mather20,
  17. M J Philippon21,
  18. M P Reiman20,
  19. A Takla3,22,23,24,
  20. K Thorborg14,
  21. S Walker25,
  22. A Weir9,26,
  23. K L Bennell23
  1. 1Warwick Medical School, University of Warwick, Coventry, UK
  2. 2University Hospitals of Coventry and Warwickshire NHS Trust, Coventry, UK
  3. 3Hip Arthroscopy Australia, Melbourne, Victoria, Australia
  4. 4St Vincents Private Hospital, East Melbourne, Victoria, Australia
  5. 5Department of Orthopaedics, Erasmus University Medical Centre, Rotterdam, The Netherlands
  6. 6Medsport, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan, USA
  7. 7Department of Clinic of Orthopaedic and Trauma Surgery, Luzerner Kantonspital, Luzern, Switzerland
  8. 8Department of Orthopaedic Surgery, Washington University School of Medicine St. Louis, St. Louis, Missouri, USA
  9. 9Aspetar, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
  10. 10Sports Surgery Clinic, Dublin, Ireland
  11. 11Department of Medicine, University College Cork, Cork, Ireland
  12. 12Southampton Football Club, UK
  13. 13Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia
  14. 14Department of Orthopaedic Surgery, Sports Orthopaedic Research Center (SORC-C), Copenhagen University Hospital, Amager-Hvidovre, Denmark
  15. 15Corades, LLC, Brookline, Massachusetts, USA
  16. 16Medical Service, Madrid Open Tennis, Madrid, Spain
  17. 17Hip Preservation Center, Baylor University Medical Center at Dallas, Dallas, Texas, USA
  18. 18Rangos School of Health Sciences, Physical Therapy, Duquesne University, Pittsburgh, Pennsylvania, USA
  19. 19UPMC Center for Sports Medicine, Pittsburgh, Pennsylvania, USA
  20. 20Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina, USA
  21. 21Steadman Philippon Research Institute, Vail, Colorado, USA
  22. 22Australian Sports Physiotherapy
  23. 23Department of Physiotherapy, The University of Melbourne, Centre for Health, Exercise and Sports Medicine, Melbourne, Victoria, Australia
  24. 24Bond University
  25. 25Coventry, UK
  26. 26Amsterdam Centre for Evidence-based Sports Medicine, Academic Medical Centre, Amsterdam, The Netherlands
  1. Correspondence to Professor DR Griffin, Clinical Sciences Research Institute, University Hospitals Coventry and Warwickshire, Coventry, CV2 2DX, UK; damian.griffin{at}warwick.ac.uk

Abstract

The 2016 Warwick Agreement on femoroacetabular impingement (FAI) syndrome was convened to build an international, multidisciplinary consensus on the diagnosis and management of patients with FAI syndrome. 22 panel members and 1 patient from 9 countries and 5 different specialties participated in a 1-day consensus meeting on 29 June 2016. Prior to the meeting, 6 questions were agreed on, and recent relevant systematic reviews and seminal literature were circulated. Panel members gave presentations on the topics of the agreed questions at Sports Hip 2016, an open meeting held in the UK on 27–29 June. Presentations were followed by open discussion. At the 1-day consensus meeting, panel members developed statements in response to each question through open discussion; members then scored their level of agreement with each response on a scale of 0–10. Substantial agreement (range 9.5–10) was reached for each of the 6 consensus questions, and the associated terminology was agreed on. The term ‘femoroacetabular impingement syndrome’ was introduced to reflect the central role of patients' symptoms in the disorder. To reach a diagnosis, patients should have appropriate symptoms, positive clinical signs and imaging findings. Suitable treatments are conservative care, rehabilitation, and arthroscopic or open surgery. Current understanding of prognosis and topics for future research were discussed. The 2016 Warwick Agreement on FAI syndrome is an international multidisciplinary agreement on the diagnosis, treatment principles and key terminology relating to FAI syndrome.

The Warwick Agreement on femoroacetabular impingement syndrome has been endorsed by the following 25 clinical societies: American Medical Society for Sports Medicine (AMSSM), Association of Chartered Physiotherapists in Sports and Exercise Medicine (ACPSEM), Australasian College of Sports and Exercise Physicians (ACSEP), Austian Sports Physiotherapists, British Association of Sports and Exercise Medicine (BASEM), British Association of Sport Rehabilitators and Trainers (BASRaT), Canadian Academy of Sport and Exercise Medicine (CASEM), Danish Society of Sports Physical Therapy (DSSF), European College of Sports and Exercise Physicians (ECOSEP), European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA), Finnish Sports Physiotherapist Association (SUFT), German-Austrian-Swiss Society for Orthopaedic Traumatologic Sports Medicine (GOTS), International Federation of Sports Physical Therapy (IFSPT), International Society for Hip Arthroscopy (ISHA), Groupo di Interesse Specialistico dell’A.I.F.I., Norwegian Association of Sports Medicine and Physical Activity (NIMF), Norwegian Sports Physiotherapy Association (FFI), Society of Sports Therapists (SST), South African Sports Medicine Association (SASMA), Sports Medicine Australia (SMA), Sports Doctors Australia (SDrA), Sports Physiotherapy New Zealand (SPNZ), Swedish Society of Exercise and Sports Medicine (SFAIM), Swiss Society of Sports Medicine (SGMS/SGSM), Swiss Sports Physiotherapy Association (SSPA).

  • Hip
  • Consensus statement
  • Diagnosis
  • Orthopaedics
  • Physiotherapy
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