Recognizing femoroacetabular impingement syndrome and delaying hip replacement

Hip pain is mostly seen in the elderly, mainly due to degenerative changes in the articular cartilage caused by decades of excessive joint axial loading of the hip joint. However, some young and middle-aged patients, especially those who exercise frequently, do show long-term pain in the hip joint, which is difficult to explain by the above pathogenesis. Currently, about 20%-30% of patients forced to undergo joint replacement due to osteoarthritis of the hip joint are caused by hip dysplasia and hip impingement syndrome (FAI), which can be completely delayed or even avoided through early diagnosis and treatment. In addition, because of the young age of these patients, the short onset time, the specific location of the lesion, and the fact that the lesion mainly involves cartilage tissue, it is difficult to detect the presence of the lesion by ordinary X-ray examination. FAI refers to an anatomical abnormality of the femur and acetabulum, and the abnormal collision between the proximal femur and the acetabular rim occurs during hip joint activities, resulting in damage to the acetabular glenoid lip and the adjacent acetabular cartilage, which causes symptoms such as hip joint pain, and eventually leads to damage to the acetabular glenoid lip and articular cartilage, which in turn causes degenerative arthritis. It is the main cause of osteoarthritis of the hip joint in young patients. Since the impact occurs when the hip joint is flexed and the impact site is mainly located in front of the hip joint, pain in the groin area often occurs, especially when squatting with the legs together. Therefore, if a young person develops groin pain with joint popping or sudden onset of interlocking symptoms, or hip pain after exertion or long distance walking, they should undergo an anterior hip impingement test and other imaging tests as soon as possible. Once hip dysplasia or FAI is diagnosed, early surgical treatment should be performed, which can delay the progression of osteoarthritis of the hip joint, thus delaying the time for hip replacement by 10 to 20 years, or even longer.