Femoroacetabular impingement

The hip joint is considered a ball-and-socket joint in which the ball of the femoral head articulates with the socket (also called acetabulum) which is a hemispherical cavity in the pelvic bone.


In femoroacetabular impingement (FAI), there are bony spurs which form on the edges of the femoral head (cam type) or the acetabulum (pincer type).

the movement of the normal hip joint
Normal hip joint

 

impingement in the cam type
Cam type

 

impingement in the pincer type
Pincer type

 

This extrabone develops because the hip bones do not form normally during the childhood growing years. In such cases, when the hip joint is moved in a certain direction to the maximum extent, the bony prominence strikes the other surface of the joint (impingement) leading to gradual damage of this surface and osteoarthritis of the hip.

 

Diagnosis:

There is usually dull aching pain in the groin and sometimes in the lower back. Sharp pain may occur while twisting and squatting. When the doctor examines the patient, he moves the hip joint to its maximum in certain directions to see if this will reproduce the pain. If in doubt, the doctor will order for X-rays, CT-scans or MRI to confirm the diagnosis and to determine the exact location and extent of the bone prominences.

 

Treatment:


Non-surgical treatment:


Most patients will be treated without the need for surgery. This can be achieved through:
• Modification of activity: avoiding activities and movements leading to impingement and pain.
• Medications: e.g. non steroidal anti-inflammatory drugs like ibuprofen.
• Physiotherapy may be helpful in some cases.

 

Surgical treatment:

If the condition is not relieved by non-surgical treatment, the patient may require surgery. This surgery may be done arthroscopically (key-hole surgery) or through an open surgery. During surgery, the bony prominences causing the impingement and pain are removed and the doctor will repair or clean out any damage in the articular cartilage.

 

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