AANA19 Hip Access Pass-Hold On: Asymptomatic FAI Exists-Dr. J.W. Thomas Byrd, M.D.

Video Transcription

Video Summary

The speaker begins by discussing their disclosures, which can be found in a handout or on their website. They then reflect on the topic of femoroacetabular impingement (FAI) and the importance of not only considering pincer and cam abnormalities, but also imaging. They highlight data from the NFL Combine that shows a high prevalence of FAI in athletes. The speaker discusses the evaluation of asymptomatic FAI, mentioning that sometimes the contralateral hip becomes symptomatic as the surgical side recovers. They emphasize the importance of pain as the main indication for hip arthroscopy and the challenges of making someone who is asymptomatic feel better. They state that FAI is a chronic process and compensatory problems can obscure the underlying joint problem, often leading to delayed diagnosis. The speaker mentions the use of in-office ultrasonography to assess hip pain and establish the clinical relevance of imaging. They highlight that not all MRI changes require surgery. The speaker notes that some individuals with FAI morphology never develop FAI pathology, indicating that other factors contribute to the development of symptoms. They discuss the importance of functional version and orientation of the pelvis in influencing FAI problems. The speaker mentions subspine impingement and its potential impact on response to intra-articular injections. They conclude by stating that asymptomatic FAI exists and cautioning against operating on asymptomatic patients, but still recommending a cautious and watchful approach to avoid irreversible damage.

Asset Caption

Concurrent Scientific Session VI: Symposium - Treatment of the Athletic Hip 5.3.2019

Keywords

femoroacetabular impingement

asymptomatic FAI

hip arthroscopy

MRI changes

pelvis orientation