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The underlying problem with FAI is a bony abnormality. This bony shape will not change with physical therapy or rest. However, the shape of the bones itself do not cause pain. Other structures that can be injured with FAI, such as the labrum, or articular cartilage may cause the pain in the hip. Neither the labrum or articular cartilage have much capacity to heal, but sometimes these structures, even when injured do not cause pain or other symptoms.
Thus, for those with symptoms the initial treatment may involve rest and rehabilitation, while those that have symptoms that persist, arthroscopic surgery may be needed. The long term sequelae of FAI has not been conclusively proven, but there is much evidence that it may be a major cause of premature arthritis of the hip.
It has also not been proven that surgery for FAI will prevent arthritis. However, removing the offending bone may help reduce further injury to the joint, while also reducing symptoms. The results of surgery are clearly better when there is no articular cartilage damage. Thus, most physicians familiar with this problem often recommend early surgical intervention for symptomatic patients with FAI.