Femoro-Acetabular Impingement

A healthy hip relies on two main bony structures to allow the hip to efficiently move in different positions. The acetabulum is the socket of the hip and femoral head is the ball of the hip. The dimensions of the acetabulum and femoral head are precisely designed to smoothly and painlessly move together.

However, genetic conditions, osteoarthritis, and injury can change the shape of the acetabulum or femoral head. A mishaped acetabulum or femoral head can lead to bones to rub against each other and cause pain.

At the American Hip Institute, an orthopedic specialist can carefully diagnose femoroacetabular impingement (FAI) and develop a treatment plan for this condition. When discussing treatment options, it is important to understand various factors that contribute to FAI.

Here are essential points covered on this page:

What is Femoroacetabular Impingement?
Symptoms of Femoroacetabular Impingement
Causes of Femoroacetabular Impingement
Diagnosis of Femoroacetabular Impingement
Treatment Options for Femoroacetabular Impingement
Surgery for Femoroacetabular Impingement

What is Femoroacetabular Impingement:

Femoroacetabular Impingement (FAI) is a cause of pain in the hip. FAI can lead to labral tears and eventually advancement of osteoarthritis. Impingement is most commonly described as overgrowth of bone along the acetabulum (socket) and femoral head (leg bone). The bony deformities lead the two bones to rub each other during certain hip motions.

There are two distinct forms of hip impingement: too deep or over-coverage of a socket, known as Pincer impingement and a non-spherical femoral head, known as Cam impingement.

Some hips have both Pincer and Cam impingement, known as Combined impingement. During hip motion, either during sports or with daily activities, the non-spherical femoral head and socket can continually meet and rub against each other, causing pinching or entrapment of the labrum, commonly leading to a labral tear or joint wear-and-tear.

Symptoms of Femoroacetabular Impingement:

Patients with a FAI may or may not experience symptoms. However, if you experience any of the symptoms below, it may indicate that you have FAI:

Popping of the hip
Pain around the groin, upper thigh, and side of the hip
Catching or locking of the hip
Pain that occurs after exercise
Stiffness or limited range of motion in the hip

If you recognize these symptoms, certified medical professionals from the American Hip Institute can perform further tests to confirm the diagnosis.

Causes of Femoroacetabular Impingement

Some people may be more susceptible to FAI due to their lifestyle, natural anatomy, or due to genetics. Heavy labor or frequent physical activity can accelerate the development of FAI. FAI can be developed from several things, including:

Avascular necrosis
Early onset osteoarthritis
Repetitive movements of the hip
Traumatic injuries, such as automobile accidents or sports injuries
Hip instability
Muscular imbalances

Diagnosis of Femoroacetabular Impingement

Diagnosing FAI in the hip can involve a multi-combatorial assessment of medical history, physical examination, and diagnostic tests. Our providers at the American Hip Institute may utilize any of the following tests to diagnose your condition:

X-Rays: Providers can rule out other possible conditions that may contribute to the pain you're experiencing. Using X-rays, they can check for structural abnormalities and fractures.

Magnetic Resonance Imaging (MRI): This imaging test can be used to evaluate the condition of the cartilage and bone that compose the hip joint. An MR arthrogram (MRA) is an imaging procedure that involves injecting a contrast dye material into the hip joint space to clearly visualize structures of the hip.

Physical Examination: Various physical examination maneuvers can test range of motion, joint stability, and pain with specific tests that are sensitive to FAI or other conditions of the hip. These tests include the flexion / adduction / internal rotation (FADIR) impingement test, which is highly sensitive to FAI.

Medical History: Our certified medical practitioners will also inquire about your medical history, including lifestyle, previous surgeries, and current symptoms.

Diagnostic Injection With Local Anesthetic: In some cases, a diagnostic injection using a local anesthetic may be administered into the joint space to determine whether a patient’s pain is stemming from damage to structures within the hip joint or structures like the lumbar spine.

Treatment Options for Femoroacetabular Impingement

Treatments for FAI vary depending on the severity of symptoms and the patient’s individual needs. Patients with a minor case of FAI may require rest for a few weeks and never require surgical intervention.

Here are some of the conservative treatment options available to you at the American Hip Institute:

Activity Modification and Rest: Doctors may recommend avoiding certain activities and opting for rest to help reduce symptoms.

Physical Therapy: Physical therapy can help improve your range of motion and strengthen the muscles supporting your hip joint.

Medications: Anti-inflammatory medications can help reduce the pain and inflammation associated with torn cartilage.

Orthobiologics: Injections that contain platelet rich plasma, bone marrow aspirate concentrate, or cortisone can provide relief to inflammation in the hip joint.

Surgery for Femoroacetabular Impingement

When conservative treatment options fail to provide relief, doctors can recommend surgery, such as hip arthroscopy. Hip arthroscopy is a minimally invasive procedure that uses poke hole incisions into the hip joint and the insertion of a camera called an arthroscope to visualize the hip.

When conservative treatment options fail to provide relief, doctors can recommend surgery, such asHip arthroscopy is a minimally invasive procedure that uses poke hole incisions into the hip joint and the insertion of a camera called an arthroscope to visualize the hip.While visualizing the hip, the surgeon may shave bony growth on the acetabulum (socket) or femoral head (ball) to eliminate the cause of FAI. Oftentimes in cases of FAI, cartilage structures in the hip like the labrum need to be repaired. Depending on the severity of damage, a labral repair or reconstruction can be performed in addition to shaving of the bony structures in the hip. If FAI has caused substantial cartilage damage, the surgeon may decide to perform microfractures to stimulate healing within the hip joint. The goal of these procedures is to preserve the structures of the hip.

Following the surgery, you will be given instructions on caring for your incisions, activities to avoid, and exercises to perform for a fast recovery and successful outcome. The use of crutches and a hip brace will be necessary for some time, depending on the procedure that was performed, to protect the newly repaired hip. Physical therapy in the following months will help you restore strength and mobility. Your surgeon will also prescribe pain medications to keep you comfortable during this time.

Meet Experts in Femoroacetabular Impingement at the American Hip Institute:

If you think you are suffering from any of the symptoms mentioned above, you may be experiencing FAI. Experts from the American Hip Institute can provide personalized treatment plans that address your individual needs. Our team uses cutting-edge therapies to diagnose and resolve hip injuries quickly so you can get back on your feet in no time. Contact us today to schedule a consultation.