If your genes have the make up that you're going to come down with osteoarthritis no matter what, we can't prevent that yet. That will be the Nobel Prize, the person who can alter the genetic machinery or magically inject into the joint the stem cells that are going to recreate cartilage. That's what many researchers are working on now.
Right now we know that FAI is a mechanical condition that will progress to arthritis if it's severe enough. If I can treat the teenage to 20-something patients before they show arthritic change, remove the mechanical problem associated with the condition, there's hope that we'll prevent arthritis and prolong the lifetime of the hip, possibly preventing hip replacement like I had. There are other types of conditions, though, that if caught early, can be corrected with non-surgical treatments, avoiding surgery altogether.
A few years ago I used to get a number of patients referred to me with FAI, so many having been sent to psychiatrists. A lot of radiologists wouldn't even pick it up on the x-ray findings. The joint didn't have bad arthritis, but nobody even noticed either the overhanging spur or the acetabulum, or the big bump on the femur, and they would tell people that they're fine. It was usually the physical therapists that would know there was something going on in there, and there wasn't a widespread knowledge of the condition. I can think of two cases where patients actually broke down in tears when I told them it wasn't all in their head. I'd do an injection in their hip joint and they'd get better, even if it was temporary, and they would be relieved to finally have a diagnosis. Then after an arthroscopic procedure, they'd get better.
It's not as common now for the problem to be overlooked. We've done a good job educating the orthopedic community so that they'll more easily identify the problem. Now I'm not seeing as many patients who were bounced around to five or six different clinicians.