The diagram to the right illustrates the three different types of Femoral Acetabular Impingement.
The hip is a ball-and-socket-joint: the femoral head forms the ball and the acetabulum, which is part of the pelvic bone, forms the socket. The labrum of the hip is a cuff of thick fibrocartilage tissue that surrounds the acetabulum. Femoral Acetabular Impingement (FAI) is a congenital abnormality of the bone in which there is an overgrowth of the bone. Overgrowth of the acetabulum (hip socket) is called a “Pincer” impingement. Overgrowth of the femoral head is called a “CAM” impingement. “Mixed” impingement represents both types combined.
The presence of FAI in some patients can go unnoticed indefinitely. However, when symptoms develop it is usually an indication of damage to the joint structure. Extra bone growth reduces space within the joint and causes structures to rub or grind against each other. Patients with FAI are more likely to experience loose bodies, labral tears, snapping hip syndrome, and arthritis.
Symptoms:
- Loss of range of motion
- Inability/weakness when moving leg across the body
- Inability/weakness when lifting leg
- Pain in the groin area
- Pinching feeling deep within the joint
- Catching/snapping sensation with specific motions
- Pain with:
- Getting into and out of the car
- Going from a sitting to stand position
- Sleeping on the affected side
- Twisting and turning motions
- Squatting motion
- Crossing legs while sitting
- Daily activity
If your symptoms last longer than 2 weeks and interfere with daily activity you should consult your primary care physician for a referral.
What To Expect During Your Appointment:
During your appointment, Dr. Betz will perform a physical exam to test range of motion in the hip and the leg strength. In-office imaging may be done or an MRI or CT Scan may be set up to diagnose the cause of your pain. CT scans provide more detail than X-ray and MRI, and can help the doctor determine the extent of bone growth abnormality. Once the results of your imaging come back, Dr. Betz will provide treatment options and help you decide the course of action that is best for you.
Treatment
Dr. Betz performs an in-office exam on the patient to check for FAI.
Non-Surgical Options:
- Rest
- Medication: non-steroidal anti-inflammatories are often prescribed to minimize swelling and pain.
- Physical Therapy: strengthening the upper leg will help relieve pain. Stretching is also performed to help regain mobility.
- Injections: If the other non-surgical treatments fail, Dr. Betz can use injections to help reduce pain.
- Steroid Injection (Cortisone): steroids are proven to be very effective at reducing inflammation and pain when injected directly into the joint space.
- Platelet Rich Plasma (PRP): your own blood is used to extract platelet-rich plasma, which is then injected into your hip joint. The platelets within the plasma stimulate the body to repair itself.
Surgical Options:
FAI rarely requires surgery. However, if non-surgical treatment fails, Dr. Betz may discuss surgery as an option. Each patient and case is different, but FAI can usually be treated arthroscopically. For more information on arthroscopic surgery please see “Arthroscopic Surgery”.
For postoperative patients: