Femoroacetabular Impingement (FAI) 2016-10-12T12:39:54+00:00

Femoroacetabular Impingement (FAI)

hip impingement Blacksburg, VA

Femoroacetabular Impingement (FAI)

A condition, known as femoroacetabular impingement (FAI), occurs when the bones of the hip are atypically shaped. This irregularity in shape prevents the bones from fitting together ideally. The hip bones rub against each other causing damage to the joint. Impingement refers to a pinching or compression of the soft tissue around the hip socket. There are several types of impingement, depending on what is compressed and where the impingement occurs.

In FAI, irregular shape of the femoral head and socket cause the hip bones to hit against each other rather than move cohesively together. Over time, this may lead to the tearing of the labrum and premature wear of the cartilage, possibly resulting in osteoarthritis.

Causes of FAI

FAI occurs when the hip bones do not form normally during the childhood growing years. It is the deformity of a cam bone spur, pincer bone spur or both, that leads to joint damage and pain. When the hip bones are shaped abnormally, there is little that can be done to prevent FAI. Active people tend to work the hip joint more vigorously and they may begin to experience pain earlier than those who are less active. However, exercise does not cause FAI.

Symptoms of FAI

The first symptoms of FAI are usually noticed deep in the groin area during activities that involve using the hip. Walking long distances can be especially difficult. Other symptoms of FAI include:

  • Sharp or stabbing pain that occurs with twisting, turning and squatting
  • Dull ache in hip that is persistent
  • Usually pain is felt on one side, but the condition is most often found in both hips
  • Groin pain after sitting for prolonged periods of time
  • Limping to favor hip due to limited motion
  • Groin pain associated by a clicking, locking or catching sensation when chronic impingement has caused a labral tear

If a labral tear is present with FAI, the symptoms get worse rapidly with long periods of standing, sitting or walking. The pain may be reproduced by pivoting on the affected leg. Some patients may have a positive Trendelenburg sign (i.e. hip drops down on the right side when standing on the left leg). Diagnostic imaging such as X-ray, injections and MRI arthrogram can assist in the diagnosis of FAI.

Non Surgical Treatment of FAI

At Sideline Orthopedics, we like to begin with offering conservative treatment of FAI if pain is manageable. We begin with activity modification. Other options for conservative treatment include:

  • Changing your daily routine and reducing or avoiding activities that cause symptoms.
  • Non-steroidal anti-inflammatory medications. Medication, like ibuprofen, can be provided in a prescription-strength form to help reduce pain and inflammation.
  • Physical therapy. Specific exercises can improve the range of motion in your hip and strengthen the muscles that support the joint. This can help to relieve some stress on the injured labrum or cartilage.
  • Some patients may also benefit from intra-articular injection with a numbing agent combined with an anti-inflammatory (steroid) medication.

Surgical Treatment

In some cases, surgery is recommended right away. As with most degenerative conditions, early diagnosis and surgical correction may be able to restore normal hip motion. Surgery is often recommended after the non-surgical treatment options have failed to relieve pain or restore hip function.

Many FAI problems can be treated with arthroscopic surgery. Arthroscopic procedures are performed with small incisions and thin instruments. The surgeon uses a small camera, called an arthroscope, to view inside the hip. During arthroscopy, the surgeon can repair or clean out any damage to the labrum and articular cartilage. Correcting the FAI can be achieved by trimming the bony rim of the acetabulum, as well as shaving down the bump on the femoral head. Some severe cases may require an open operation with a larger incision, but this is rare.

Dr. Bart Eastwood is one of the few surgeons in the region with both experience and fellowship training in hip arthroscopy to treat FAI and labral tears.

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