Femoroacetabular Impingement (FAI)

Femoroacetabular impingement (FAI), or hip impingement, is a type of bony overgrowth in the hip. It can lead to pain that prevents you from staying active.

FAI can happen to anyone but is most common in active people, especially during the teen years.

At the Adolescent and Young Adult (AYA) Hip Preservation Program at UPMC Children's Hospital of Pittsburgh, we treat young people with FAI. We offer both surgical and nonsurgical treatments to help you manage your hip pain.

Contact the AYA Hip Preservation Program

To make an appointment with one of our orthopaedic experts or ask a question about FAI care, call 412-692-5530.

What Is Femoroacetabular Impingement (FAI)?

Your hip joint is a ball-and-socket. The top of your femur (thigh bone) is the ball and part of your pelvic bone (the acetabulum) is the socket.

With FAI, your femur and/or socket aren't shaped correctly. As a result, they rub one another in a way that prevents your hip from moving normally.

FAI causes

The changes in the shape of the ball or socket tend to happen toward the end of growth. The ball part of the joint loses its perfect roundness and/or the socket can over or under-develop. It's equally common in men and women, and it is not yet clear if genetics play a role.

Being active or playing a certain sport doesn't cause FAI. Rather, active people are more likely to notice hip pain sooner than others.

FAI risk factors and complications

Over time, FAI can cause damage to your cartilage — mostly to the labrum.

The labrum is the "O ring" of soft tissue that goes around the socket and forms a tight seal. This is what helps the ball move smoothly within the socket. It also keeps the ball in place.

Though there's no way to prevent FAI, there are ways to treat and manage it.

FAI Symptoms and Diagnosis

With FAI, you may have hip pain that feels worse when you exercise. You may also feel pain after long periods of squatting or sitting. Pain from FAI can make it hard to play a sport you love.

People with FAI often describe symptoms such as:

  • A clicking, popping, or pinching feeling in the hip or groin area.
  • Groin pain that wraps around the back of your hip.
  • Stiffness in your hip.

For some people, the pain may go away on its own. If it doesn't, the experts at the AYA Hip Preservation Program are ready to help diagnose and treat your FAI.

Diagnosing hip impingement

To help diagnose FAI, we will:

  • Take your medical history.
  • Do a physical exam, including range of motion tests, to see how your hips move.

To confirm hip impingement, we may order X-rays to get an overall look at the ball-and-socket joint.

Once we confirm FAI, we'll then want to see how severe it is. There are two advanced imaging tests that can help us determine severity:

  • A CT scan gives us a 3D view of your hip joint.
  • An MRI shows the soft tissue of your hip joint and can spot damage to the labrum.

At the AYA Hip Preservation Program, we have specialized training in reading these scans. That matters for helping you get timely diagnosis and treatment for your hip condition.

FAI Treatment

We want to help young people be active or play the sports they love pain-free. We'll tailor your treatment based on your physical examination findings and individual goals.

Nonsurgical treatments for hip impingement

Before suggesting surgery, we always start with these nonsurgical treatments for FAI:

  • Physical therapy. Increasing strength in the muscles around the hip joint can help stabilize your hip and reduce pain.
  • Anti-inflammatory medicine. For some people, reducing painful swelling will help the hip feel better and move more normally.

Surgery for FAI

If your FAI doesn't improve after trying nonsurgical treatment, we have surgical treatment options. Surgery may also be a good option for people who have labrum damage.

Surgeries for FAI include:

  • Hip arthroscopy. We use a small camera (an arthroscope) to look inside your hip. We can repair cartilage or shave off excess bone. This is a minimally invasive surgery because it only requires small incisions.
  • Surgical dislocation. We carefully take the hip out of the socket so that we have complete access to the joint. We can shave off pieces of bone or reshape them to relieve impingement. Our surgeons have expertise in this surgery.

If you have surgery for FAI, we help to rehabilitate your hip so you can make a full recovery. Our physical therapy team gets involved at the start of your treatment and stays with you each step of the way.

Why choose the AYA Hip Preservation Program to treat hip impingement?

We bring a level of expertise to treating FAI and hip injuries that's unmatched in the Pittsburgh region.

  • Michael McClincy, MD, is one of a handful of surgeons in the region who performs advanced hip surgeries for conditions like FAI.
  • We take a team approach to diagnose and treat young people with FAI.
  • We run research studies out of our clinic that help advance how we treat hip disorders. It also means you get early access to new treatments.

Make an Appointment at the AYA Hip Preservation Program

To make an appointment for FAI care, call 412-692-5530.