Femoroacetabular Impingement (FAI), Hip Impingement

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Femoroacetabular impingement (FAI) or hip impingement can happen to anyone, at any age, but is most commonly experienced by active individuals. FAI occurs as a result of too much friction in the hip joint produced by bony irregularities. The result is often pain and decreased range of hip motion.

At OrthoAspen, our elite-grade specialists routinely address conditions affecting the health of the hips, including hip impingement. We know how much our patients value their active lifestyle. It’s our commitment to help you find a solution to return you to the activities you love most as soon as possible—safely and effectively.

Causes & Symptoms

When the femoral head and acetabulum rub against each other, damage and pain develop in the hip joint. The damage can occur to the articular cartilage (the smooth white surface of the ball or socket), or the labral tissue (the lining of the edge of the socket) during normal movement of the hip. The articular cartilage or labral tissue can fray or tear after repeated friction. Over time, more cartilage and labrum is lost leading to bone-on-bone friction, commonly referred to as osteoarthritis.

The two most common forms of hip impingement are:

  • Cam Impingement
    The cam form of impingement is when the femoral head and neck aren’t perfectly round (due to excess bone that has formed). The lack of roundness and excess bone causes abnormal contact between the surfaces.
  • Pincer Impingement
    The pincer form of impingement occurs as a result of the socket (acetabulum) rim experiencing overgrowth. Eventually, it covers too much of the femoral head resulting in the labral cartilage being pinched. The pincer form of impingement may also be caused when the hip socket is abnormally angled backward. This causes an abnormal impact between the femoral head and the rim of the acetabulum.

Most diagnoses of FAI include a combination of the cam and pincer forms.

Symptoms of femoroacetabular impingement include:

  • Groin pain associated with hip activity
  • Pain in the front, side or back of the hip
  • Pain described as a dull ache or sharp pain
  • Hip locking, clicking or catching sensation
  • Pain that occurs to the inner hip or groin area after prolonged sitting or walking
  • Pain in the lower back
  • Pain in the buttocks or outer thigh area

Some patients may also experience difficulty walking, especially at an incline. Other symptoms may vary depending on the severity of the condition.

Risks

Certain physical situations and conditions increase the risk of developing femoroacetabular impingement, which include:

  • Active athletes, such as football players, weightlifters and hockey players
  • Heavy laborers
  • Individuals who experience hip flexion
  • Individuals with congenital hip dislocation
  • Patients with pre-existing anatomical abnormalities of the femoral head or angle of the hip
  • Patients diagnosed with Legg-Calves-Perthes disease: a form of arthritis in children where the blood supply to the bone is impaired causing bone breakdown
  • Hip that has been subjected to trauma
  • Individuals with inflammatory arthritis
Diagnosis

At OrthoAspen, our orthopedic hip specialists will go over your medical history, perform a physical examination and conduct any necessary diagnostic studies including X-rays as well as MRI and CT scans to properly diagnose your hip condition.

Treatment

If hip impingement is diagnosed, our OrthoAspen physicians will always attempt to first apply conservative treatment options.

Nonsurgical management of FAI, will probably not change the underlying abnormal biomechanics of the hip, although it may offer pain relief and improved mobility.

Conservative FAI treatments include:

  • Rest
  • Activity modification and limitations
  • Anti-inflammatory medications
  • Physical therapy
  • Injection of steroid and analgesic into the hip joint

When conservative measures are not enough to relieve the symptoms of hip impingement, your OrthoAspen physician may recommend surgical treatment.

Hip arthroscopy is a common surgical solution to addressing femoroacetabular impingement.

Regardless of what treatment option your OrthoAspen orthopedic specialist suggests for optimum results, rest assured that we will do whatever we can to make you as comfortable as possible, with the swiftest, safest recovery possible.

If you’re concerned that you may be experiencing a hip condition in need of assessment, please click here to request an appointment with one of our physicians or call us at 970-544-1289.

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Visit OrthoAspen in two convenient locations
Aspen Clinic
Aspen Valley Hospital
0401 Castle Creek Rd., Suite 2100,

Aspen, CO 81611
+(970) 544-1289
+(970) 544-1400
Basalt Clinic
Midvalley Medical Center
1450 E. Valley Rd., Suite 201,

Basalt, CO 81621
+(970) 544-1289
+(970) 544-1400