Types of FAI
FAI is classified according to the anatomical source of the impingement. Most patients present with features of both types simultaneously — known as combined impingement.
Cam Impingement
An abnormal bony prominence on the femoral head or neck creates an aspherical shape. As the hip flexes, this bump contacts the acetabular rim, shearing the adjacent cartilage and labrum.
Pincer Impingement
Excess coverage of the femoral head by the acetabulum causes the labrum to be pinched between the acetabular rim and the femoral neck with deep hip flexion.
Combined
Elements of both cam and pincer morphology present simultaneously — the most common presentation seen clinically.
Symptoms & Consequences
FAI typically presents in active young and middle-aged adults. Symptoms often develop gradually, though they may be precipitated by a specific activity or event.
- Deep groin pain, often described as a dull ache that becomes sharp with certain movements
- Pain with hip flexion activities — sitting for prolonged periods, squatting, cycling, or pivoting sports
- Reduced hip internal rotation, particularly in the flexed position
- Clicking, catching, or giving-way sensations within the joint
- Stiffness and discomfort after periods of rest or inactivity
If left untreated, the repetitive mechanical trauma of impingement can cause progressive cartilage delamination and labral tearing, ultimately accelerating the development of hip osteoarthritis. Early diagnosis and management are important in preventing long-term joint damage.
Treatment
Management begins with conservative measures. Where these fail to provide adequate relief, or where significant joint damage is evident, surgical correction is considered.
- Activity modification — avoiding movements that provoke impingement to reduce ongoing damage
- Physiotherapy — targeted strengthening of hip stabilisers, optimising neuromuscular control and movement patterns
- Anti-inflammatory medication and corticosteroid injection — to manage pain and facilitate rehabilitation
- Arthroscopic surgery — the definitive treatment for symptomatic FAI with labral or cartilage involvement. The procedure involves resecting the cam lesion (femoroplasty) and/or trimming excess acetabular rim (rim trimming), combined with labral repair or reconstruction. Most patients experience significant pain relief and improved function.
Discuss Hip Impingement
For a personalised assessment and treatment plan, contact Dr. Pirpiris’s rooms at Cabrini Medical Centre, Malvern.
📞 Call 03 9508 9600