Femoroacetabular impingement (FAI)

What Is Femoroacetabular Impingement (FAI)?

Femoroacetabular impingement (FAI) is a condition characterized by abnormal contact between the ball (femoral head) and the socket (acetabulum) of the hip joint. This abnormal contact can cause damage to the cartilage and labrum (the ring of cartilage that surrounds the acetabulum), leading to pain and restricted movement. FAI typically affects young and middle-aged adults and is a common cause of hip pain and dysfunction.

What Are the Types of Femoroacetabular Impingement?

– Cam Impingement: Caused by an abnormal bony growth on the femoral head that creates an irregular shape, leading to friction within the hip joint.

– Pincer Impingement: Occurs when there is excessive coverage of the femoral head by the acetabulum, leading to pinching of the labrum.

– Combined (Cam and Pincer) Impingement: A combination of both cam and pincer impingement, where both the femoral head and the acetabulum have abnormalities contributing to the impingement.

What Causes Femoroacetabular Impingement?

– Genetic Factors: Inherited structural abnormalities of the hip joint.

– Developmental Issues: Abnormal hip development during childhood and adolescence.

– Repetitive Motion: Activities that involve frequent hip flexion, such as certain sports.

– Previous Hip Injuries: Trauma or injury to the hip joint.

– Bone Spurs: Growth of extra bone along the edges of the hip joint.

– Hip Dysplasia: Misalignment or malformation of the hip joint.

– Arthritis: Degenerative changes in the hip joint.

– Obesity: Increased stress on the hip joint.

What Are the Symptoms of Femoroacetabular Impingement?

– Hip Pain: Typically in the groin area, but may also be felt on the outside of the hip.

– Stiffness: Reduced range of motion in the hip joint.

– Clicking or Locking: Sensation of the hip catching or locking during movement.

– Pain During Activity: Pain that worsens with physical activity or prolonged sitting.

– Limping: Altered gait due to pain or stiffness.

How Is Femoroacetabular Impingement Diagnosed?

– Physical Examination: Initial assessment by a healthcare provider to evaluate symptoms and range of motion.

– X-rays: Primary imaging technique to visualize bone structure and identify abnormalities in the femoral head and acetabulum.

– MRI: Provides detailed images of soft tissues, including the labrum and cartilage.

– CT Scan: Offers cross-sectional views of the hip joint for detailed assessment.

– Hip Impingement Test: Specific physical maneuvers to reproduce symptoms and confirm diagnosis.

What Are the Risk Factors for Developing Femoroacetabular Impingement?

– Age: Most common in young and middle-aged adults.

– Gender: Slightly more common in males.

– Athletic Activity: High levels of physical activity, especially those involving hip flexion.

– Previous Hip Injuries: History of hip trauma or surgery.

– Genetics: Family history of hip disorders.

– Obesity: Increased body weight stressing the hip joint.

What Are the Long-Term Complications of Untreated FAI?

– Chronic Pain: Persistent and worsening hip pain.

– Osteoarthritis: Degenerative joint disease leading to cartilage wear and tear.

– Joint Stiffness: Increased difficulty in moving the hip joint.

– Labral Tears: Damage to the labrum, causing pain and instability.

– Loss of Mobility: Progressive reduction in hip joint function.

– Disability: Severe cases may lead to significant functional impairment.

– Surgical Intervention: Delayed treatment may necessitate more complex surgeries.

Femoroacetabular impingement (FAI) IN PROFESSIONAL SPORTSMAN

Femoroacetabular impingement (FAI) is considered one of the main causes of hip osteoarthritis in young adults, especially in athletes. Development of hip impingement seems to occur most frequently in sports involving quick accelerating weight-bearing motions and sudden changes in direction, such as football, tennis, and handball

The femoral head-neck deformity associated with the cam type of FAI was observed in 61.6% of professional football players as per study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10880309/

What Non-Surgical Treatments Are Available for Femoroacetabular Impingement?

– Physical Therapy: Exercises to improve strength, flexibility, and range of motion.

– Anti-inflammatory Medications: Drugs to reduce pain and inflammation.

– Activity Modification: Avoiding activities that exacerbate symptoms.

– Injections: Corticosteroid or hyaluronic acid injections to relieve pain.

– Weight Management: Maintaining a healthy weight to reduce stress on the hip joint.

– Assistive Devices: Using canes or crutches to support mobility.

– Heat and Cold Therapy: Applying heat or ice packs to reduce pain and inflammation.

When Is Surgery Necessary for Femoroacetabular Impingement?

Surgery is often necessary for FAI when conservative treatments fail to provide sufficient relief, and the patient continues to experience significant pain and functional impairment. Surgery may also be recommended if there is evidence of damage to the cartilage or labrum that needs to be addressed to prevent further deterioration of the hip joint. The decision to proceed with surgery is made based on the severity of symptoms, the extent of joint damage, and the patient’s overall health and activity level.

What Are the Surgical Options for Treating Femoroacetabular Impingement?

– Arthroscopic Surgery: Minimally invasive procedure using small incisions and specialized instruments to reshape the bone and repair damaged tissues.

– Open Surgery: Traditional approach involving a larger incision to access the hip joint and perform necessary repairs.

– Labral Repair: Reattachment or reconstruction of the torn labrum.

– Osteoplasty: Surgical reshaping of the femoral head and/or acetabulum to improve joint mechanics.

– Capsular Plication: Tightening of the hip capsule to improve stability.

– Debridement: Removal of damaged tissue and bone spurs.

– Periacetabular Osteotomy (PAO): Realignment of the acetabulum to improve coverage of the femoral head.

What Happens During Surgery for Femoroacetabular Impingement?

During surgery for femoroacetabular impingement, the patient is typically placed under general anesthesia to ensure comfort and pain-free experience throughout the procedure. The surgeon makes incisions near the hip joint to access the affected areas. Using specialized instruments, the surgeon reshapes the femoral head and/or acetabulum to eliminate the abnormal contact and improve joint mechanics. Any damaged tissue, such as the labrum, is repaired or removed as necessary.

Arthroscopic surgery, being minimally invasive, involves smaller incisions and the use of a camera to guide the surgical instruments. Open surgery, while more invasive, may be required for more complex cases. The goal of the surgery is to restore normal hip function, alleviate pain, and prevent further joint damage.

What Is the Recovery Process Like After Surgery for Femoroacetabular Impingement?

The recovery process after surgery for femoroacetabular impingement varies depending on the type of surgery performed and the individual patient’s condition. Initially, patients may experience pain and swelling, which can be managed with medications. Physical therapy usually begins soon after surgery to promote mobility and prevent stiffness.

Patients are often encouraged to bear weight on the operated leg gradually, using crutches or a walker as needed. Recovery time can range from a few weeks to several months, with full return to activities taking up to six months. Regular follow-up appointments with the surgeon are essential to monitor progress and ensure proper healing.

The success of the surgery depends on various factors, including the patient’s overall health & adherence to post-operative care

Address FAI with Dr. Ponnanna’s specialized treatments, relieving pain and restoring hip function. Enjoy a more active lifestyle. Book your appointment today for expert care.