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Introduction
The concept of hip impingement has been appreciated since at least 1936. 1 Ganz et al 2 discussed femoroacetabular impingement (FAI) in more detail in 2001, reporting a new surgical approach, and then presenting a hypothesis linking FAI with osteoarthritis in 2003. 3 This, and the introduction of an arthroscopic approach to surgery in the early 2000s, led to increasing interest in this condition; the number of patients identified with FAI has risen rapidly over the past 10 years. 4-6 In parallel, there has been a rapid increase in the number of publications. In 2012, Clohisy and Kim 7 organised a meeting of predominantly orthopaedic surgeons to summarise the literature on FAI, develop consensus and consider how best to design future research. 8-13
In recent years, the number of patients being treated for FAI has risen sharply in many countries. 5 6 14 Clinicians, funders and health systems are concerned about this rise in a previously unrecognised condition, the costs and uncertainties of treatment, the lack of clarity of the epidemiology and the ambiguity of the diagnostic criteria.
To guide patients, clinicians and funders, we convened a consensus meeting. Our aim was to reach an international multidisciplinary agreement on the diagnosis and management of FAI syndrome.
Methods
Panel selection
We invited representatives from a range of professions and specialties to join a consensus panel. We included sport and exercise medicine physicians, physiotherapists, orthopaedic surgeons and radiologists, who are most closely involved in managing these patients. We invited people who were known to have a research interest and clinical practice in FAI syndrome, and asked professional organisations with a known interest to nominate suitable people (International Society for Hip Arthroscopy, International Federation of Sports Physical Therapy and American Medical Society for Sports Medicine). We aimed to have representation from around the world, and deliberately chose people who we knew to hold disparate views, representing as wide a spectrum of opinion as possible. In total, 22 expert clinicians and academics, and 1 patient, from 9 countries and 5 specialties, participated in the process and are the authors of this article.
Preliminary work
We developed a list of topics and questions that we hoped to answer, circulating ideas around the panel until there was agreement. We searched...