Intra-articular hip disorders in the military population: evaluation and management

The physical demands of the military expose the hip to extreme forces and stresses and generate a high incidence of hip disorders within this population. Fundamental to the pathophysiology of hip injuries is the underlying anatomy of the joint because problematic femoroacetabular mechanics predispose to injury. FAI is increasingly recognized as the underlying cause of hip disorders and should be considered when assessing a patient with hip complaints. Young, male patients are at increased risk of FAI, especially cam impingement, and high levels of athletic activity during skeletal growth may contribute to the development of cam morphology. A complete evaluation requires a careful history and physical examination combined with multiple imaging modalities. Conservative treatment is indicated for acute hip injury to allow alleviation of inflammation and restoration of normal gait and range of motion. Surgery should be considered for refractory dysfunction, mechanical symptoms, or significant deformities. Arthroscopy has revolutionized the treatment of hip injuries in young, active patients, and is likely to continue to expand in use.