The hip is a ball and socket joint. The ball is the femoral head and the socket is part of the pelvis called the acetabulum. A thin smooth layer of cartilage (articular cartilage) covers both the femoral head and the acetabulum and allows low friction motions as the surfaces glide over each other. The acetabulum has a strong layer of cartilage (the labrum) that is on the outer margin of the bone forming a seal or gasket around the socket.

The strong ligaments and tissue that surround the joint and hold it together is the capsule. The inside of the capsule is lined by a thin layer of tissue called the synovium that produces fluid that lubricates the joint.

Femoral Acetabular Impingement (FAI)

The hip is responsible for supporting the majority of the bodies weight. It is critical to have a well functioning hip to walk, run, and jump and perform most daily activities. Femoral acetabular impingement (FAI) is a condition caused by abnormal bone growth on the femoral neck (CAM impingement), on the socket (pincer), or both (combined) impingement. This condition causes repetitive trauma to both the labrum and articular cartilage with certain movements.

Symptoms of FAI include pain in the groin, thigh, or buttock, clicking or locking sensations, sharp pain when squatting, twisting, or running.

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The reasons people develop FAI vary. Some people are at risk because of developmental issues, the bones of the pelvis and femur did not form normally during childhood. Other risk factors include young athletes who participate in multiple sports, those with a history of trauma to the hip, and those with osteoarthritis of the hip.

Diagnosis starts with a thorough history and physical exam, imaging (including X-ray and possibly more advanced imaging such as MRI), and other tests to rule out other common conditions that can present in a similar fashion.


Non-operative: Usually a course of non-surgical treatment is initiated. This includes activity modification, oral anti-inflamatories, physical therapy, and occasional injections.

Surgical Treatment

Hip arthroscopy is a surgical procedure that allows the surgeon to get access to the hip joint through very small incisions, causing little soft tissue trauma. The goal is to repair any damaged labral or articular cartilage, remove any abnormal bone that is causing the impingement, and restore normal motion and function to the joint. It is performed as an outpatient procedure and has had great success in the treatment of FAI and labral tears that are unresponsive to more conservative care.

Hip replacement is considered if the articular cartilage damage is so significant that it cannot be addressed arthroscopically. If there is advanced arthritis a hip replacement is the surgery of choice.

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