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Femoroacetabular impingement
Femoroacetabular impingement is a lack of room between the ball and socket of the hip joint, and certain structures can be pinched and/or damaged as the hip is taken through a normal range of motion. One type of impingement that can occur is based on the socket side where the femoral head is out-of-round. Since the femoral head does not have a typical spherical shape, repetitive microtrauma to the hip joint can lead to tearing of the labrum. Another problem that impingement may cause is Damage to the articulate cartilage
Patients with this condition often experience pain located in the groin. This is made worse with activities such as putting on socks and shoes, prolonged sitting or participating in activities that require squatting, such as getting in and out of a chair or car. Many female patients will often report pain in the groin with intercourse.
Femoroacetabular impingements, as well as other deformities of the hip joint, are associated with an increased risk of developing arthritis of the hip. However, this is not a direct cause-and-effect relationship.
Treatment typically includes an initial trial of non operative treatment including physical therapy and anti-inflammatory medications. The goal of physical therapy is to strengthen the muscles surrounding the hip and provide better stability for the hip joint. Often patients who participate in physical therapy aimed at increasing the range of motion will notice an increase in their symptoms.
If conservative treatments fail to provide adequate relief, arthroscopic surgery may be an option. Surgery typically involves a detailed arthroscopic exam of the hip to address any associated findings such as a labral tear or articular cartilage damage. Also, the bones can be slightly reshaped to prevent further impingement from occurring.
Like many joint preservation techniques, the extent of the damage that has already occurred is often the limiting factor. For patients who have significant arthritic changes, the results of arthroscopic
surgery have not been encouraging; however, in the absence of arthritic findings, results of arthroscopic surgery have been very promising.
Javad Parvizi, Michael Leunig, and Reinhold Ganz. Femoroacetabular Impingement J. Am. Acad. Ortho. Surg., September 2007; 15: 561 - 570.
Reviewed By: G. Peter Maiers II, MD
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