What is FAI and what are the options for recovery?
FAI, otherwise known as femoroacetabular impingement, is an anatomic abnormality of the acetabulum and/or the femoral head that increases the joint contact forces. This eventually leads to degenerative changes in the labrum and associated joint cartilage. FAI has 3 types: Cam (femoral head abnormality), pincer (acetabulum abnormality) and mixed. These patients tend to participate in a strict physical therapy regimen, however when conservative treatment has failed, surgery is indicated. There are many options available to the surgeon, however arthroscopic management has been growing more popular due to the decreased complications and faster recovery.
A new study from June 2022, investigated the risk factors for revision surgery and progression to Total Hip Arthroscopy (THA) in patients who underwent surgery for symptomatic FAI. After performing their meta-analysis, they discovered that the overall rate of revision was 5.29% (351/6641 patients) following FAI surgery, while the rate of THA was 3.78% (263/6966). They also found that BMI at baseline, labral debridement, and acetabular index (useful in determining dysplasia and is normally 330 to 380) were associated with increased progression to THA. “High lateral center-edge angles and low acetabular indices, which require more complex surgical techniques for adequate treatment, are [also] associated with higher rates of revision surgery.”
Overall, FAI corrective surgery can be helpful for patient’s pain and leads to good outcomes. The revision rate is lower than anticipated when we first read this article. However, with a good surgeon and quality physical therapy regimen, patients can rest assured that revision surgery is a low risk if taken proper precaution. If you are in the Mission Viejo area and think you, or someone you know, might benefit from physical therapy, please don’t hesitate to reach out!
1. Migliorini F, Maffulli N, Baroncini A, Eschweiler J, Tingart M, Betsch M. Revision Surgery and Progression to Total Hip Arthroplasty After Surgical Correction of Femoroacetabular Impingement: A Systematic Review. The American Journal of Sports Medicine. 2021;50(4):1146-1156. doi:10.1177/03635465211011744