This week we discuss outcomes with femoroacetabular impingement syndrome FAIS), defined as "as a clinical triad of symptoms, signs, and imaging findings related to the underlying hip pathology." There are three bony morphologies associated with FAIS: cam, pincer, and mixed. Cam morpohlogy is a bony growth on the femoral head/neck, while a pincer morphology is bony growth of the acetabulum. Mixed morphology is the presence of both cam and pincer changes. Symptoms of FAIS include hip/groin pain, pain worse with motion or certain positions, clicking/locking/stiffness, decreased hip strength/ROM, and impaired balance. The FADDIR test, commonly associated with a clinical diagnosis of FAIS, actually has poor sensitivity and specificity (41% and 47%). Early activity modifications may be necessary to manage symptoms, which involves generally avoiding repetitive hip flexion and internal rotation and limiting end-range stretching of the hip, especially in the presence of pain. Studies also demonstrate hip muscle weakness in the presence of FAIS symptoms, which could be a focus of rehab interventions. Conservative management of FAIS for a minimum of 3 months has shown to be successful in 39-82% of FAIS cases, and it is likely successful conservative management is related to the radiographic severity of morphology. Most reviews demonstrate that surgery has improved short term outcomes (<1 year) compared to physical therapy in young, active populations. Although, the return to play rate after hip arthroscopy was 85.4%, which took an average of 6.6 months. One article found that 1 in 4 athletes don’t return to previous level of sport participation after hip arthroscopy for FAIS.

The abstract can be found here: https://pubmed.ncbi.nlm.nih.gov/37650998/

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