Understanding femoroacetabular impingement
THE femoroacetabular impingement, often abbreviated as CFA, Hip dysplasia is a hip condition that is increasingly diagnosed, particularly in young and athletic individuals. It involves abnormal contact between the head of the femur and the rim of the pelvis (the acetabulum), causing repeated friction during movement.
Over time, this friction can damage the structures of the joint, particularly the labrum and the cartilage. That's why this condition should not be neglected, especially in athletes who put a lot of stress on their hips.
Femoroacetabular impingement typically causes a groin pain or a hip pain during certain specific movements, and can become disabling if no treatment is implemented.
Why did this conflict arise?
Femoroacetabular impingement is usually related to an abnormal shape of the joint.
There are two main types of conflict:
- CAM-type conflict
In the type of conflict CAM, The head of the femur is not perfectly round. During flexion, it comes up against the rim of the pelvis.
This type of conflict is common among young athletes, especially those who trained intensely during adolescence.
- PINCHING type conflict
In the type of conflict PINCH, It is the pelvis that covers too much of the head of the femur.
Abnormal contact also occurs during certain movements, causing repeated pain.
- Mixed form
In many cases, the patient presents a combination of both mechanisms.
This mixed form is common and can be more aggressive to the cartilage.
The most common symptoms
The main symptom of femoroacetabular impingement is a groin pain.
This pain often occurs:
- during hip flexion
- in a prolonged sitting position
- during or after sports
- during rotational movements
The patient often describes a profound discomfort, sometimes associated with a feeling of blockage or stiffness.
The pain can also radiate:
- towards the thigh
- towards the knee
- sometimes in the buttock
Why are athletes more affected by femoroacetabular impingement?
Athletes place greater stress on their hips due to repetitive movements, changes of direction, accelerations, and significant ranges of motion. Over the long term, these stresses can contribute to the development of femoroacetabular impingement (FAI) or other hip pathologies.
The sports most affected are:
- soccer
- hockey
- dance
- martial arts
- CrossFit
These disciplines involve repeated flexion, rotation, and pivoting movements that increase mechanical stress on the joint. When these stresses are repeated over several years, they can lead to abnormal friction between the femoral neck and the acetabular rim, gradually contributing to the development of pain and decreased mobility.
Early intervention often makes it possible to adapt sports practice, limit the progression of injuries, and continue physical activity under good conditions.
The role of the labrum and cartilage
THE labrum is a fibrocartilaginous ring that surrounds the acetabulum* and contributes to hip stability. It also helps distribute stress and protect the articular cartilage during movement.
Repeated friction can cause:
- a labral tear
- cartilage wear
These lesions are often responsible for pain, decreased mobility, and discomfort during sports activities or everyday movements.
Without appropriate care, these conditions can progress gradually and promote the development of a early hip osteoarthritis, sometimes occurs at a relatively young age. Early intervention helps to preserve the joint and limit this progression.
*A cavity in a bone into which the head of another bone fits and articulates, especially in the hip
How to diagnose femoroacetabular impingement?
The diagnosis is based first on a clinical examination.
The doctor looks for movements that trigger the pain, particularly flexion-rotation.
Tests are often necessary:
- X-ray
- Hip MRI
- arthro-MRI in some cases
These examinations allow visualization of the conflict and associated injuries.
What treatments?
Treatment depends on the severity of the symptoms.
In moderate cases, conservative treatment may be sufficient:
- sports adaptation
- relative rest
- rehabilitation
- anti-inflammatories
Rehabilitation aims to improve mobility, strengthen muscles and reduce stress.
When is surgery necessary?
Surgery is considered when pain persists despite well-conducted treatment (rehabilitation, adaptation of activities, medication or injections), or when femoroacetabular impingement or a labral injury risks progressively damaging the cartilage.
L'arthroscopy hip allows you to:
- correct the bone anomaly responsible for the conflict,
- to repair or treat a labral tear,
- preserve cartilage by limiting abnormal friction.
Made of in a minimally invasive way, This procedure aims to provide lasting pain relief, improve mobility, and reduce the risk of developing early-onset hip osteoarthritis. A complete clinical and radiological assessment is always performed to confirm the need for surgery and to determine the most appropriate treatment.
Can we continue playing sports?
It depends on the intensity of the pain, the sport practiced, and the extent of the injury. In some cases, appropriate physical activity can be continued, provided that movements that cause pain are avoided.
Low-impact sports, such as cycling or swimming, are often better tolerated. Conversely, activities involving pivoting, changes of direction, or repeated impacts can increase friction in the hip and promote the worsening of labral or cartilage damage.
The goal is therefore not to stop sport altogether, but to adapt it temporarily To protect the joint while maintaining good physical condition, a specialist consultation can help determine the most suitable activities for each individual situation.
Conclusion
THE femoroacetabular impingement is a common cause of hip pain in young, athletic people. Often overlooked, it can nevertheless be responsible for chronic pain and contribute to premature wear and tear of the joint.
Groin pain during sports, prolonged sitting, or certain bending movements should raise suspicion of this diagnosis. The earlier treatment begins, the better the chances of relieving pain and preserving the joint.
Thanks to accurate diagnosis and appropriate treatment, whether conservative or surgical, it is often possible to return to sporting activity and avoid progression to a hip osteoarthritis.
