Femoroacetabular Impingement (FAI) Overview

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Questions and Answers

What type of impingement is characterized by a nonspherical femoral head?

  • Labral Impingement
  • Pincer Impingement
  • CAM Impingement (correct)
  • Mixed Impingement

Pincer impingement occurs due to a perfectly shaped femoral head.

False (B)

What are the common symptoms of Femoroacetabular Impingement?

Pain in hip, limited range of motion, and pain with hip rotation.

The tear most commonly associated with Femoroacetabular Impingement is the __________ tear.

<p>labral</p> Signup and view all the answers

Match the type of impingement with its description:

<p>CAM Impingement = Nonspherical femoral head Pincer Impingement = Overhanging acetabular rim Mixed Impingement = Combination of CAM and Pincer Labral Tear = Fibrocartilaginous rim injury</p> Signup and view all the answers

Which activity is NOT a common cause of FAI?

<p>Yoga (D)</p> Signup and view all the answers

FAI can occur without any symptoms in some individuals.

<p>True (A)</p> Signup and view all the answers

What type of tests are used to reproduce symptoms of Femoroacetabular Impingement?

<p>Impingement Tests such as FADIR.</p> Signup and view all the answers

The primary consequence of untreated Femoroacetabular Impingement is the development of __________.

<p>osteoarthritis</p> Signup and view all the answers

Which group is more likely to experience Femoroacetabular Impingement?

<p>Adolescents and athletes (D)</p> Signup and view all the answers

What is indicated by a positive test during hip examination?

<p>Reproduction of symptoms (D)</p> Signup and view all the answers

Surgical treatment for Femoral Acetabular Impingements includes arthroscopic resection and labral repair.

<p>True (A)</p> Signup and view all the answers

What are the initial two movements performed during a passive hip examination?

<p>Flexion and External Rotation</p> Signup and view all the answers

During the labral repair, flexion is limited to ______ degrees.

<p>80-90</p> Signup and view all the answers

Match the treatment phase with its description:

<p>Phase I = Protected weight-bearing, gentle isometric exercise, ROM within pain-free range Phase II = Progression of strengthening and ROM Phase III = Full activities without restrictions</p> Signup and view all the answers

What is a conservative treatment for Femoral Acetabular Impingements?

<p>Mobility and strengthening exercises (C)</p> Signup and view all the answers

Weight-bearing restrictions after surgery last for four weeks.

<p>False (B)</p> Signup and view all the answers

What are the primary symptoms indicative of Femoral Acetabular Impingements?

<p>Pain and/or clicking</p> Signup and view all the answers

_______ and _______ are movements included in the passive internal rotation examination.

<p>Adduction, Extension</p> Signup and view all the answers

How long is the expected full range of motion achieved post-rehabilitation?

<p>By 4-6 weeks (B)</p> Signup and view all the answers

Flashcards

What is Femoroacetabular Impingement (FAI)?

A condition where the hip joint's shape is abnormal, causing bone-on-bone rubbing, pain, limited movement, and potential cartilage damage.

What is CAM Impingement?

A type of FAI where the femoral head (top of thigh bone) is not perfectly round, leading to a 'bump' causing rubbing.

What is Pincer Impingement?

A type of FAI where the acetabulum (hip socket) has extra bone growth, making the rim stick out and pinch the femoral head.

What is Mixed Impingement?

This type of FAI involves both CAM and Pincer impingement, combining the issues of an abnormal femoral head and an over-grown acetabulum.

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How does Pincer Impingement affect the labrum?

The labrum is a ring of cartilage attached to the acetabulum, deepening the hip socket and providing stability. In Pincer Impingement, this labrum can be damaged, leading to instability and increasing the risk of arthritis.

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How does CAM Impingement affect the cartilage?

In CAM Impingement, the femoral head's shape causes cartilage damage. This damage occurs because the cartilage layers of the hip joint separate, making the surface rough and prone to wear.

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What is a common cause of FAI?

Repetitive activities like sports (hockey, soccer, running) can lead to FAI. Repeated stress on the hip joint contributes to the condition.

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What are some common symptoms of FAI?

FAI can cause hip pain, limited range of motion, and discomfort in specific movements like rotating the hip or transitioning from sitting to standing.

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What are Impingement Tests like FADIR?

These tests are used to diagnose FAI by reproducing the patient's symptoms. They involve specific movements of the hip.

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What is a Labral Tear?

A labral tear happens when the labrum - the cartilage ring in the hip socket - is ripped or torn.

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How is a Labral Tear related to FAI?

Labral tears are often linked to FAI, as the abnormal hip joint puts extra stress on the labrum.

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What are some causes of a Labral Tear?

Traumatic events like sudden impacts and repetitive stress from activities (sports) can cause labral tears.

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Where is the most common location of a Labral Tear?

The most commonly affected part of the labrum in a tear is the front portion.

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What are some symptoms of a Labral Tear?

Labral tears cause hip pain, clicking in the hip joint, and discomfort with certain movements like rotating the hip or sitting for long periods.

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What is Conservative Treatment for a Labral Tear?

Exercises to improve mobility and strengthen muscles around the hip.

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What is Surgical Treatment for a Labral Tear?

Surgical options include removing damaged labral tissue or repairing the tear. Both options have specific restrictions and recovery periods.

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What is Labral Debridement?

Removing damaged labral tissue. Patients need to restrict weight-bearing and have no range of motion (ROM) limitations.

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What is Labral Repair or Refixation?

This involves fixing the torn labrum back in place. Patients need to limit external rotation, flexion, and weight-bearing.

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What is Phase I Rehabilitation for Labral Tears?

This phase focuses on gentle exercises and regaining range of motion.

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What is Phase II Rehabilitation for Labral Tears?

This phase involves building strength and gradually increasing range of motion.

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Study Notes

Femoroacetabular Impingement (FAI)

  • A condition caused by an abnormal shape of the hip joint, affecting either the acetabulum (hip socket) or the femoral head (top of the thigh bone).
  • Leads to bone-on-bone rubbing, causing pain, limitation in range of motion (ROM), and potential damage to the joint cartilage.
  • Untreated FAI can lead to osteoarthritis.
  • Common in adolescents, adults, and athletes of all ages.

FAI Classification

  • CAM Impingement: Non-spherical femoral head.
  • Pincer Impingement: Overhanging rim of the acetabulum at the anterolateral aspect, characterized by extra bone growth.
  • Mixed: Both CAM and Pincer types present.

FAI - Damage to the Hip Joint

  • Pincer Impingement: Damage to the acetabular labrum, a ring of cartilage that helps stabilize the hip joint, and potential articular damage, increasing the risk of osteoarthritis.
  • CAM Impingement: Non-perfectly round femoral head engages with the acetabulum, causing articular cartilage damage due to delamination (separation of cartilage layers).

Etiology and Symptoms of FAI

  • Etiology: Repetitive stress activities, common in athletes such as hockey players, soccer players, runners, and dancers.
  • Symptoms: Hip pain, limited ROM, painful hip rotation, pain after prolonged sitting, and pain during sit-to-stand motions.
  • Diagnosis: Impingement tests like the Forced Flexion, Adduction, and Internal Rotation (FADIR) test can reproduce symptoms.

Labral Tear

  • Commonly found in conjunction with FAI.
  • Can occur due to trauma or repetitive stress activities.
  • Most common site for a tear is ANTERIOR.
  • Labrum is a fibrocartilaginous rim attached to the acetabulum, deepening the hip socket and providing stability.

Labral Tear Symptoms

  • Hip or groin pain.
  • Catching or clicking in the hip joint.
  • Painful hip rotation.
  • Aggravated by prolonged sitting, standing, or walking.
  • Stiffness or limited ROM in the hip joint.

Labral Tear Treatment

  • Conservative Treatment: Mobility and strengthening exercises.
  • Surgical Treatment: Arthroscopic resection/debridement or labral repair.
    • Labral Debridement: Removal of damaged labral tissue, with 2 weeks of weightbearing (WB) restrictions and no ROM limitations.
    • Labral Repair or Refixation: External rotation (ER) limited for 4 weeks with antirotation bolster, flexion limited to 80-90 degrees, and 50% body weight WB.

Rehabilitation for Labral Tears

  • Phase I (Protected WB): Gentle isometric exercises, ROM within pain-free range.
  • Phase II: Progression of strengthening and ROM exercises.
  • Full ROM is expected by 4-6 weeks.

Testing for Anterior Labral Tear

  • A specific test involves bringing the hip into flexion, external rotation, and abduction, followed by passive internal rotation, adduction, and extension.
  • A positive test reproduces symptoms such as pain and/or clicking.

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