The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement

Abstract

The 2016 Warwick Agreement on femoroacetabular impingement (FAI) syndrome was convened to build an international, multidisciplinary consensus on the diagnosis and management of patients with FAI syndrome. 22 panel members and 1 patient from 9 countries and 5 different specialties participated in a 1-day consensus meeting on 29 June 2016. Prior to the meeting, 6 questions were agreed on, and recent relevant systematic reviews and seminal literature were circulated. Panel members gave presentations on the topics of the agreed questions at Sports Hip 2016, an open meeting held in the UK on 27-29 June. Presentations were followed by open discussion. At the 1-day consensus meeting, panel members developed statements in response to each question through open discussion; members then scored their level of agreement with each response on a scale of 0-10. Substantial agreement (range 9.5-10) was reached for each of the 6 consensus questions, and the associated terminology was agreed on. The term 'femoroacetabular impingement syndrome' was introduced to reflect the central role of patients' symptoms in the disorder. To reach a diagnosis, patients should have appropriate symptoms, positive clinical signs and imaging findings. Suitable treatments are conservative care, rehabilitation, and arthroscopic or open surgery. Current understanding of prognosis and topics for future research were discussed. The 2016 Warwick Agreement on FAI syndrome is an international multidisciplinary agreement on the diagnosis, treatment principles and key terminology relating to FAI syndrome.

Femoroacetabular impingement syndrome – a pain in the hip

“…4 In order to be diagnosed with FAI syndrome, the patient requires the predisposing morphology (as evidenced on imaging) in addition to appropriate symptoms and clinical signs. 5 always played regular sport. The condition may even present in very sporty teenagers.…”

“…Physiotherapy rehabilitation aims to improve hip stability, neuromuscular control, strength, range of motion and movement patterns. 5 Physiotherapy involving stretching and education in techniques to avoid impingement-inducing movements has been shown to have some benefits. 13 Intra-articular injections of steroid and local anaesthetic have a role, both as a diagnostic and therapeutic tool.…”

Clinical Measures of Hip Range of Motion Do Not Correlate With the Degree of Cam Morphology in Semi-Elite Australian Footballers: A Cross-Sectional Study

“…2 Hip related groin pain in young athletes is often attributed to Femoroacetabular Impingement Syndrome (FAIS). 3 Cam morphology is the most common type of FAIS. 3 Cam morphology likely develops during adolescence when the proximal femoral growth plate is open 4 and there is some evidence to suggest this is correlated with training load(s) during this period.…”

“…3 Cam morphology is the most common type of FAIS. 3 Cam morphology likely develops during adolescence when the proximal femoral growth plate is open 4 and there is some evidence to suggest this is correlated with training load(s) during this period. [5][6][7] The implications of these morphologies are still not thoroughly understood, and cam morphology has been proposed as a risk factor of hip osteoarthritis.…”

Cumulative Effects of Occupational Loading as a Risk Factor for Hip Pain in UK Military Personnel - Study Protocol of a Case Control Study

“…These conditions are not necessarily mutually exclusive and may be inter-related. FAI is recognized as a common cause of non-arthritic hip pain and is defined as a motion-related clinical disorder of the proximal femur and acetabulum that may result in pain and decreased function [6,7]. This impingement is caused by abnormal morphology of the femoral head/neck junction (cam impingement), acetabular rim (pincer impingement) or both [8].…”