Clinical Decision-Making in FAIS

Summary

Femoroacetabular impingement syndrome is increasingly recognized as a contributor to cartilage injury and early hip osteoarthritis. Both structured conservative care and arthroscopic surgery can improve pain and function, but a major unresolved clinical problem is deciding who should continue conservative care and who should escalate to surgery, and when. Evidence indicates that shorter symptom duration before surgery is associated with better long-term improvement, meaning delays may reduce the chance of achieving meaningful recovery. Current decision-making still depends largely on static imaging and passive clinical examination, which do not capture the dynamic, movement-related nature of the condition, while advanced three-dimensional imaging and laboratory motion analysis are not practical for routine clinical monitoring. This study aims to address this gap by developing and validating feasible, clinic-ready dynamic assessment methods and integrating weight-bearing pelvic and spinal alignment with three-dimensional hip modeling to support more objective, individualized, and timely treatment decisions.

Conditions

• Femoracetabular Impingement

Interventions

DIAGNOSTIC_TEST

Functional lateral x-ray scans

Functional lateral x-ray scans will be obtained in three postures: standing, relaxed sitting, and deep flexed sitting. This previously validated protocol, provides posture-specific measures of spinopelvic alignment under physiological load and allows to integrate weight-bearing spinopelvic alignment into 3D hip coverage analysis. By extending imaging beyond a femur-centric perspective, this method better reflects the dynamic, multi-regional nature of FAIS.

DIAGNOSTIC_TEST

Multi-echo Fast Field Echo (mFFE) MRI

A multi-echo Fast Field Echo (mFFE) MRI will be acquired to generate highcontrast, bone-like images without ionizing radiation. The imaging sequence can be readily implemented on standard 1.5T and 3T MRI scanners available at the collaborating sites. An in-house pipeline will enable automated 3D segmentation of the lumbar spine, pelvis, acetabulum, proximal femur and condyles.

DIAGNOSTIC_TEST

Markerless 3D motion capture

Participants will complete markerless 3D motion capture during three hip-hinge tasks: deep squat, sumo squat, and Romanian deadlift (20% body weight). Lumbar, pelvic and hip movements will be measured in all three planes. Data will be recorded using two research-dedicated iPads running the movement tracking software.

DIAGNOSTIC_TEST

Marker-based 3D motion capture (optional)

In a subgroup of participants, during three hip-hinge tasks: deep squat, sumo squat, and Romanian deadlift (20% body weight). Lumbar, pelvic, and hip movements will be measured in all three planes using our validated marker-based 3D motion capture system.

Sponsors & Collaborators

• Universitaire Ziekenhuizen KU Leuven

  lead OTHER

Principal Investigators

• Stijn Ghijselings, Dr. · Universitaire Ziekenhuizen KU Leuven

Study Design

Allocation

NON_RANDOMIZED

Purpose

DIAGNOSTIC

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

35 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2026-07-31

Primary Completion

2029-07-31

Completion

2029-07-31

Countries

• Belgium

Study Locations