Hip

Impingement

Overview

Femoroacetabular impingement (FAI) is a condition in which extra bone grows along one or both of the bones that form the hip joint — giving the bones an irregular shape. Because they do not fit together perfectly, the bones rub against each other during movement. Over time this impingement can damage the joint, causing pain and limiting activity. It can also result in tears to the labrum and osteoarthritis.

Symptoms of impingement include:

  • Pain often occuring in the groin area, although it may occur toward the outside of the hip or buttock
  • Pain with prolonged sitting in an upright position is the most common symptom
  • Pain at the extremes of motion or with aggressive physical activity
  • Turning, twisting, and squatting may cause a sharp, stabbing pain
  • Sometimes, the pain is just a dull ache
  • Stiffness and limping

Diagnosis

As part of the physical examination, your doctor will put your hip through a wide range of motions including several specific maneuvers in an attempt to elicit your pain and determine if impingement is present.

X-rays, computed topography (CT) scan, or magnetic resonance imaging (MRI) may also help determine whether you have FAI.

Treatment Options

Treatment for hip impingement may begin with resting the affected hip and modifying your activities to avoid moving the joint in a way that causes pain. Your doctor may also recommend physical therapy to strengthen the muscles that support the hip and your core or anti-flammatory pain medications. If these treatments do not relieve pain, your doctor may recommend hip impingement surgery.

The earlier you have surgery, the greater your chances of a complete recovery. But even if cartilage has been damaged, surgery may still reduce pain and improve range of motion. Many FAI problems can be treated with arthoscopic surgery. However, if the cartilage damage is severe, hip replacement may be the only treatment that will relieve pain and improve function.

Proximal Femoral Osteoplasty

Proximal femoral osteoplasty is a surgical procedure which corrects structural abnormalities that can contribute to abnormal hip mechanics, impingement, and pain.

Physical Therapy

Your doctor may recommend physical therapy to help you regain strength in your hip and to restore range of motion. After your procedure, you may need to use a cane, crutches, or a walker for a time.