FAI, Chondral lesions/loose bodies, & Labral Tears

FAI causes abnormal forces within the hip joint that lead to clinical symptoms and may drive the progression of

primary hip osteoarthritis

type of FAI where the femoral neck & head, usually found in younger athletic males

CAM FAI

type of FAI where the depth of the acetabulum has increased depth, mostly found in 20-40 y/o females

Pincer FAI

FAI signs ROM deficit with

flexion and internal rotation at 90 degrees of flexion

Warwick Agreement (Griffin 2016)

○ Must have all three to be given a diagnosis of FAI

Symptoms

○ Signs

○ Radiographic Evidence

Boney morphology

The labrum is what type of stabilizer

rotary

hip labral tears have limited ROM deficits in IR and flexion, but mostly

end range deficits

what is the best diagnostic imaging for hip labral tear?

MR w/ Arthrography (~90% sensitivity & specificity)

common ROM impairments in FAI/Labral tears

tight hip flexors, pain at end range of flexion & IR

common strength impairments in FAI/labral tear

hip ER, Abd, extension weakness

quad & gastroc/soleous weakness

core weakness/motor control

the hip flexor is commonly misdiagnosed as a cause of symptoms, but in fact it is

a result of compensation due to another issue

common movement patterns w/ FAI & labral tear

Increased pelvic motion with squatting

• Anterior pelvic tilt

• Dynamic valgus

• Internal rotation and adduction of the hip during dynamic single leg tasks

chondral lesions and loose bodies usually present in the hip under load during

mid-range movement (squatting), it is also inconsistent

Formation of loose bodies within the hip joint secondary can lead to

abrasion of the articular cartilage and cause progressive breakdown

risk factors of osteonecrosis of femoral head

Prior trauma

•Long-term corticosteroid use

•Chronic alcohol consumption

•Connective tissue diseases (especially lupus)

•Pelvic Radiation s/p CA treatment

what is the condition where the femoral head slides off the femoral neck, affects males more during pubescent years

slipped capital femoral epiphysis (SCIPY)

Obligatory abduction and ER with passive flex, seen in SCIPY

Drehmann sign