What is a hip impingement?

Femoroacetabular (hip) impingement (FAI) is a hip orthopedic condition where new bone grows along the bones that form the hip joint. The new bones will have an unbalanced shape and won’t fit together properly, causing them to rub against each other during movement. Gradually this friction will damage the joint.

Causes of femoroacetabular (hip) impingement

Femoroacetabular impingement (FAI) occurs when the hip bones don’t form properly during childhood development. If the hip bones are not shaped properly, FAI can develop over time.

Many patients who have FAI do not experience symptoms. Athletes are more likely to experience symptoms earlier than other people who do not move the hip joint vigorously. If symptoms develop, the disease is likely to progress to the point where treatment is crucial.

Risk factors for femoroacetabular (hip) impingement

Risk factors for developing femoroacetabular impingement include:
  • Certain sports — athletes such as runners, hockey players, football players and weight lifters
  • Repetitive hip flexion
  • Anatomical abnormalities of the femoral head or angle of the hip
  • Trauma to the hip

Symptoms of femoroacetabular (hip) impingement

The most common symptoms of femoroacetabular impingement include:
  • Pain in the groin or outside of the hip
  • Stiffness
  • Limping
  • Stabbing pain when turning, twisting or squatting

Diagnosis of femoroacetabular (hip) impingement

FAI can be diagnosed in a physical exam with your primary care or orthopedic doctor. Your physician will take a full medical history, as well as determine what causes the pain, where the pain is and what makes the pain worse.
  • Physical exam — during the physical exam, your physician will examine the hip and pelvic areas to look for areas of tenderness, as well as try to replicate the pain to confirm the area where pain is greatest.
  • Diagnostic imaging — your doctor will order an x-ray, MRI or CT scan to look at the bone and surrounding tissues and confirm the diagnosis. The x-ray will be able to show the femoral head.

Treatment for femoroacetabular (hip) impingement

If you suspect you have FAI, home remedies such as resting and anti-inflammatory medication can relieve the symptoms.

If the pain progresses, more advanced treatments must be tried to correct the biomechanics of the hip.

  • Corticosteroid — to reduce pain and inflammation
  • Physical therapy and rehabilitation
  • Surgical repair

When conservative treatments fail, hip arthroscopy to repair FAI is indicated. Hip arthroscopy is a surgical procedure where small incisions are cut and a camera and surgical instruments are inserted into the hip area to repair the labrum or clean out the hip.

Having surgery as early as possible will maximize success rates for this procedure.
More complicated cases require open surgery to correct the issue.

Recovery from femoroacetabular (hip) impingement

When surgery is done early in the progression of the disease, patients can return to everyday activities without pain. All the damage caused by the hip impingement may not be reversed even with surgery, and other hip conditions can surface later in life.

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