Femoro-acetabular Impingement

The hip is a ball and socket joint and in most people, the ball matches the socket, allowing for a good functional range of movement without problems. In some people, the two don’t match perfectly and either the ball or the socket is abnormal. This leads to problems with certain movements and impingement occurs when the two surfaces abut each other.

Sometimes, the socket faces in a slightly different position and sometimes, the area of the hip bone just below the ball has a lump which gets in the way particularly on bringing the hip up towards the body or twisting inwards. This impingement can pinch the soft tissues around the hip leading to a labral tear. The labrum is a cartilage structure around the lip of the socket, which deepens the socket. Over time, the impingement can cause damage to the surface of the joint, which can manifest as wear and tear arthritis in the hip. (Osteo-arthritis of the hip)

Symptoms of Femoro-acetabular Impingement

Common symptoms of FAI are pain particularly with twisting movements or on bending or crouching. Clicking is sometimes noticed and this can also be painful.

Treatments for Femoro-acetabular Impingement

Sometimes activity modification can reduce or control the symptoms. If the pain is only felt with a certain movement (and this can be avoided) then altering activities may prove beneficial. Painkilling/anti-inflammatory tablets or injections may be useful for symptom relief but obviously don’t treat the underlying cause. When all other measures fail, a hip arthroscopy can be considered. This is a keyhole procedure aimed at looking at the inside of the hip and trimming or repairing the torn labrum (cartilage), as well as removing the bony areas getting in the way. A single night in hospital is usually required and crutches may be necessary for a few weeks. Physiotherapy is often required to return to all activities.

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Clinicians

Emergency clinicians

Mr. Brian Cohen
MD FRCS (Tr&Orth)
Mr. Jig Patel
MB BS FRCS (Tr&Orth)
Mr. Rohit Madhav
MB BS FRCS (Tr&Orth)
Mr. R. Lloyd Williams
MB BS FRCS (Tr&Orth)
Mr. Sean Curry
MB BS FRCS (Tr&Orth)