The etiology of femoroacetabular impingement: what we know and what we don't.

CONTEXT

Several risk factors may cause femoroacetabular impingement (FAI). Knowledge of causation would identify patients for early intervention, prior to the development of painful intra-articular damage.

DATA SOURCES

PubMed, MEDLINE, EMBASE, and related article reference lists were screened for relevant studies published between January 2000 and December 2013.

STUDY SELECTION

Inclusion criteria were (1) etiology of FAI, (2) original FAI clinical data, and (3) English language. Case reports of fewer than 3 patients were excluded.

STUDY DESIGN

Systematic review.

LEVEL OF EVIDENCE

Level 4.

RESULTS

In all, 754 studies were screened, with 18 meeting the eligibility criteria. There were 13 comparative observational studies and 5 case series. The studies pertained to intrinsic patient factors (n = 2), activity/developmental factors (n = 8), hip disease (n = 5), postsurgical changes (n = 2), and malunion after hip fracture (n = 1).

CONCLUSION

A combination of intrinsic patient and developmental factors, activities involving repetitive hip motion, pediatric hip disease, and hip-related surgical procedures may contribute to the development of FAI.