Treatment of Mild Cam Morphology

Understanding Cam Morphology vs. FAI Syndrome

The British Journal of Sports Medicine recommends that cam morphology (alpha angle >60°) should not automatically require treatment, as incidental findings are common in asymptomatic individuals 1, 3
Diagnosis should never be made on imaging alone—cam morphology only becomes clinically significant when combined with hip-related pain and positive clinical examination findings (such as positive FADIR test) 1, 2

The British Journal of Sports Medicine suggests that no treatment is required for asymptomatic cam morphology—these patients should be educated about activity modification to avoid repetitive deep hip flexion and internal rotation movements that increase impingement risk 1
Monitor for development of symptoms with annual clinical assessment 1
Activity modification to avoid provocative positions (deep flexion with internal rotation) is recommended 1, 2
NSAIDs may be used for symptomatic relief during acute pain episodes 4

The British Journal of Sports Medicine recommends that surgical correction (arthroscopic cam resection/femoral osteoplasty) should be considered when conservative management fails after 3-6 months of appropriate physical therapy 2, 4
Surgical correction should also be considered for persistent hip-related pain with positive clinical examination findings (positive FADIR test) 1, 2
The American Academy of Orthopaedic Surgeons suggests that MRI or MR arthrography demonstrates associated labral tears or chondral damage requiring concurrent treatment 5, 6, 2

The American Academy of Orthopaedic Surgeons recommends that for grade 2-3 chondral lesions <3 cm², microfracture during arthroscopic cam resection produces substantially higher functional scores than chondroplasty alone 5, 6, 7
For grade 4 chondral defects, microfracture achieves 93% defect fill with good-quality fibrocartilage at second-look arthroscopy 5, 6, 7
For larger defects >2 cm² with Tönnis grade 2 osteoarthritis, matrix-assisted autologous chondrocyte implantation (MACI) produces superior outcomes compared to simple debridement 5

The British Journal of Sports Medicine warns that operating on imaging findings alone—cam morphology without clinical symptoms—does not warrant surgery 1, 3, 2
Delaying advanced imaging when surgery is being considered can lead to missed labral tears, chondral defects, or ligamentum teres pathology that may require concurrent surgical treatment 2, 4