What is Femoroacetabular Impingement (FAI)?

Femoroacetabular Impingement (FAI) involves abnormal contact between the hip joint's ball and socket, leading to joint damage and pain. Common in young athletes, FAI can be effectively managed and treated with early diagnosis and appropriate interventions, including advanced hip arthroscopy techniques with Dr. Ritesh Shah in Chicago.

Femoroacetabular Impingement (FAI) is a condition characterized by abnormal contact between the ball (femoral head) and socket (acetabulum) of the hip joint. This irregular friction results from extra bone growth, leading to damage over time, pain, and limited activity. FAI is often seen in young athletes but can affect anyone. If you’re an active adult needing a top hip arthroscopy surgeon in Chicago, understanding FAI and its treatments is crucial.

Anatomy and Pathophysiology Of The Hip Joint

The hip joint is a ball-and-socket structure:

  • Acetabulum: Part of the pelvis bone forming the socket.
  • Femoral Head: Upper end of the femur forming the ball.

In FAI, the irregular shape of these bones causes them to rub together improperly, leading to joint damage.

Types of Femoroacetabular Impingement (FAI):

FAI is classified into three main types:

  1. Pincer Impingement: Extra bone extends over the acetabulum, crushing the labrum.
  2. Cam Impingement: The femoral head is not round and cannot rotate smoothly, causing cartilage damage.
  3. Combined Impingement: Both pincer and cam types are present, exacerbating the damage.

Causes and Risk Factors for FAI:

FAI is primarily due to abnormal bone development during childhood. Factors include:

  • Genetic Predisposition: Inherited traits can contribute to abnormal bone shapes.
  • Athletic Activities: Overuse of the hip joint during high-impact sports can lead to FAI.

Symptoms of FAI often include:

  • Hip Pain: Especially during activities involving hip flexion or prolonged sitting or pivoting.
  • Stiffness: Limited range of motion in the hip joint.
  • Clicking or Locking Sensations can occur due to labral tears or cartilage damage.

Diagnosing FAI involves a combination of physical Examination and imaging tests:

  1. Physical Examination includes the anterior impingement test, in which the knee is brought toward the chest and rotated inward. Other very specific examination maneuvers are also performed.
  2. Imaging Tests:
    • X-rays: Identify bone abnormalities or signs of arthritis.
    • CT Scans: Provide detailed images of bone shapes.
    • MRI: Visualize damage to the labrum and cartilage.

Treatment Options for Femoroacetabular Impingement:

  • Non-Surgical Management
    • Physical Therapy: Focuses on improving hip strength and flexibility.
    • Medications: NSAIDs like ibuprofen and naproxen for pain relief.
    • Activity Modification: Avoiding activities that exacerbate symptoms.
  • Injections

When conservative treatments for FAI fail, surgery may be necessary:

  • Arthroscopy: Minimally invasive, using small incisions and instruments to repair or clean out damaged tissues and correct bone abnormalities.
  • Open Surgery: Required in severe cases for more extensive correction.

Outcomes and Prognosis After Surgery

  • Arthroscopic Surgery: Generally successful in reducing symptoms and preventing further joint damage.
  • Open Surgery: Effective for severe cases but involves a more extended recovery period.

Long-term outcomes are favorable, especially when diagnosed and treated early before developing arthritis.

Recent studies focus on:

  • Efficacy and Safety of Surgical Interventions: Understanding the long-term success rates.
  • Role of Inflammation and Immunology in FAI: Exploring how inflammation contributes to joint damage.
  • Non-Operative Management Protocols and Outcomes: Developing effective conservative treatment plans.

Showcasing Dr. Ritesh Shah’s Expertise

Dr. Ritesh Shah is one of Chicago’s preeminent orthopedic surgeons specializing in hip arthroscopy. Dr. Shah has built a reputation for excellence in hip and knee treatments with a rich blend of advanced training, extensive experience, and a dedication to patient-centered care.

Why Choose Dr. Ritesh Shah?

  • Board-Certified Expertise: Dr. Shah is a board-certified orthopedic surgeon specializing in hip and knee joint preservation, arthroscopy, replacement, and revision surgery.
  • Fellowship-Trained: He received highly specialized training in hip arthroscopy during his fellowship at Washington University in St. Louis, a leading institution in orthopedic surgery.
  • Pioneer in Technique: Dr. Shah is one of the first fellowship-trained surgeons in Chicagoland to perform hip arthroscopy. His specific techniques have returned so many collegiate and semi-professional athletes back to play.
  • Patient-Centered Care: Dr. Shah enjoys treating active, athletic patients, aiding them in their return to high activity levels using novel, cutting-edge surgical techniques. His approach is empathetic, innovative, and timely, ensuring that the most current clinical outcomes data validate all treatments.
  • Global Recognition: He is recognized internationally and frequently treats patients traveling worldwide seeking specialized care.
  • Educational Leadership: Dr. Shah chaired the “Annual Hip Preservation and Reconstruction” teaching course, attracting numerous colleagues worldwide to learn about advanced hip arthroscopy techniques.  He has also published Pocket Orthopedic Surgery, a manual for orthopedic residency and sports medicine training.

Surgical Excellence

Dr. Shah performs a wide array of hip surgical procedures, including:

  • Hip Arthroscopy for Labrum Repairs: A micro-invasive same-day surgical procedure using a small handheld camera called an arthroscope.
  • Minimally Invasive and Muscle-Sparing Total Hip Replacements: Advanced techniques that minimize tissue damage and promote faster recovery.

Dr. Shah is dedicated to using the most advanced and innovative techniques to provide the best outcomes for his patients, ensuring that they can return to their daily activities and active lifestyles as quickly and safely as possible.

Schedule A Hip Arthroscopy Consultation Today

If you’re an active adult experiencing hip or knee pain and considering hip arthroscopy, Dr. Ritesh Shah and his Illinois Bone & Joint Institute team are here to help. Schedule a consultation today to learn more about your treatment options and how Dr. Shah’s expertise can guide you toward recovery.


FAI is a significant orthopedic condition that can lead to chronic pain and disability if untreated. Early diagnosis and appropriate management, whether conservative or surgical, are essential to improving patient outcomes and preserving hip function. For those seeking advanced treatment options, Chicago offers top-notch hip arthroscopy services, making it possible to return to a pain-free, active lifestyle.

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