Femoral Acetabular Impingment (FAI): overview and treatment options

Dear Ask The Doctor: I have been diagnosed with Femoral Acetabular Impingment (FAI) with a slight labiel tear. I have been told nothing but surgery can fix this until I was just recently told there is a steroid shot that can fix it. I do not believe it can perminately fix this problem if it is impingment (CAM and pincer). What is your view and can I get more information on this shot? What is the Success rate? Thank you

Dear Lauren: FAI is a suggested diagnosis for pain in the hip when there is no other apparent cause in young and middle-aged adults. It is produced when too much friction occurs in the hip joint. FAI can have 2 types: CAM and Pincer. The CAM is when the femoral head and neck relationship is not perfectly round.  This loss of roundness contributes to abnormal contact between the head and socket. The Pincer form is when the socket or acetabulum has too much coverage of the ball or femoral head. FAI is associated with cartilage damage, labral tears, early hip arthritis, hyperlaxity, sports hernias, and low back pain. The conservative treatment options involve a change in lifestyle from active to less active and a commitment to maintaining hip strength, avoiding excessive hip movement and regular non-steroidal anti-inflammatory medication. Nonoperative management will not change the underlying abnormal hip biomechanics of FAI and may contribute to further hip degeneration. The steroid shot that you mentioned is used to control pain and inflammation, it is not a cure. Operative management of FAI can be addressed via hip arthroscopy or open surgery, mostly to repair when there are labral and/or cartilage damages. Generally, FAI is a chronic condition that does not typically respond to hip injections or physical therapy over the long term.