There is no passion to be found in playing small- in settling for a - - PowerPoint PPT Presentation

IT’S ALL ABOUT THE FAI! (IF IT’S

NOT THE GROIN . . OR BOTH!)

John J Christoforetti, MD Pittsburgh, Pennsylvania

There is no passion to be found in playing small- in settling for a life that is less than one is capable of living.

• Nelson Mandela

Functional Demand Mechanical Structure Genetic/Biomaterial

Conflict of Interests?

Image: British Journal of Sports Medicine 2016

“red zoning” in sport

Conflict-Free Hip Joint ROM Sport-Required ROM Adjacent segment strain! Adjacent segment injury

Identification of Symptom Generator

 Physical Exam !!:

 ?Limited hip motion relative to

sport

 ?structural FAI

 Femoral version anomaly

 Normal hip ROM with excessive

ROM sport?

 Hockey, soccer

 Palpable inguinal or boney

pelvic tenderness at muscular

• rigins?

 Sit-up test?  Valsalva?

Bisciotti GN et al. BMJopenSport&Exercise.2017

My Treatment Algorithm

HIP “Redzone” plus FAI?

Exam C/W Groin/Abdominal Injury? Exam c/w Hip Pain?

Correct FAI

Ultrasound Guided Intraarticular Injection & Reexamination!

Sports Possible?

Reduce Redzoning

Treat Groin

Reduce Redzoning

?!

Conclusions?

Meaningful symptoms and disability from the hip require hip diagnosis and treatment. Meaningful symptoms and disability from the groin or abdomen require treatment of the groin or abdomen. Combinations of symptoms are common and require systematic approach and common sense judgements- primum non nocere!

THANK YOU

Happy Holidays & Prosperous New Year!