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Frequently Asked Questions about Hip Pain: Femoroacetabular Impingement (FAI)

Your hip joint is comprised of a “ball” and a “socket”—where your femoral head fits into the acetabulum of your pelvic bone. The overall joint is held strongly together by the architecture of the bones and surrounding ligaments. And, as with every joint in your body, any misalignment or bone overgrowth will cause a disruption in the rotation of your hip.

In this article we’re going to talk about the times when your hip joint is impinged, or—more specifically—Femoroacetabular Impingement (FAI).  Below you can explore the most frequently asked questions about FAI and find out what your symptoms are saying.

Dr. Steve Hamilton, of Beacon Orthopaedics & Sports Medicine, is a sports medicine physician and orthopaedic surgeon who specializes in arthroscopic surgery of the hip. If any of your symptoms are severe, or you’ve lost mobility in your hip, please schedule an appointment with Dr. Hamilton now.

What is FAI in the hip?

Hip impingement, also known as Femoroacetabular Impingement (FAI), is a condition in which there is abnormal and wearing contact between the femoral head and the acetabulum of the hip joint, resulting in increased friction during hip rotations that will damage the joint over time. In FAI, your hip joint will develop a bone overgrowth or bump around the femoral head, along the acetabulum, or a combination of both. There are three types of FAI:

  • Pincer. This type of impingement occurs because a bone overgrowth extends out over the normal rim of the acetabulum and causes unnecessary friction between the acetabulum and the femoral head. The labrum can be crushed under the prominent rim of the acetabulum as a result.
  • Cam. In cam impingement the femoral head is not round and cannot rotate smoothly inside the acetabulum. A bump forms along the edge of the femoral head, making the ball too large to fit perfectly in the socket, and grinds against the cartilage inside the acetabulum.
  • Combined. Combined impingement that both the pincer and cam types are present.

What does a hip impingement feel like?

The top sensations of hip impingement are stiffness in the groin, pain in the front of the thigh or down the buttocks, popping or clicking in the front of the hip as you move, and/or a loss of your hip’s full range of motion. Because this condition is gradual, you may only feel sharp pain when you move the hip near its limits of motion at first. As your symptoms continue, the pain and loss of mobility intensifies.

What are symptoms of hip impingement?

While hip impingement symptoms aren’t as pronounced in the early stages, there are definite symptoms to look out for.

  • Pain when you rotate your hip
  • Pain while getting into or out of a chair
  • Pain after sitting for prolonged periods of time
  • Pain while walking uphill
  • Stiffness in the thigh, hip, or groin
  • The inability to flex the hip beyond a right angle
  • Aching or pains after running or jumping
  • Pain during or after twisting or pivoting
  • Getting into or out of a car

What are the main causes of FAI?

  • A deformity at the top of the femur
  • A deformity of the acetabulum
  • Legg-Calve-Perthes disease
  • Slipped capital femoral epiphysis
  • Coxa vara

Is FAI genetic?

FAI is generally caused by deformities in the femur, acetabulum or a combination of both. The condition may begin at birth (congenital), but it can also develop as a child grows (acquired)—while not definitely genetic the condition tends to be caused by a combination of genetic and environmental and habitual factors of the individual in question.

What is the best way to diagnose hip impingement?

If you experience symptoms of hip impingement, your physician can diagnose the problem based on your description of your symptoms, a physical exam, and the findings of the following imaging tests:

  • X-Ray
  • Magnetic Resonance Imaging (MRI)
  • CT Scan

If your symptoms are severe, please schedule an appointment with Dr. Hamilton now so we can get you on the path to recovery.

Is there a nonsurgical treatment for FAI?

Symptoms can be minimized by the following activities you can practice at home:

  • Daily routine changes to avoid activities that cause symptoms.
  • Taking non-steroidal anti-inflammatory medications (NSAIDS) to alleviate the pressure and inflammation in the joint.
  • Strengthening exercises and physical therapy to relieve some stress on the injured labrum or cartilage.
  • Resting the affected hip.

If these treatments do not relieve your symptoms, hip impingement surgery might be your best option for recovery.

What is FAI surgery?

Often, surgery for hip impingement can be performed arthroscopically. This minimally invasive technique involves inserting a lighted scope and tools through small incisions over your hip instead of making a large incision. And, because arthroscopy is usually an outpatient surgery, you will be able to have the procedure done and go home the same day.

At Beacon, Dr. Hamilton specializes in arthroscopic surgery of the hip. If you feel your condition might warrant a surgery to reduce the hip pain, schedule an appointment now.

What is the recovery time for hip impingement surgery?

Physical therapy typically begins within 1-2 days after surgery.  Most patients have protected range of motion and partial weight bearing with crutches for the first 4-6 weeks.  Patients can gradually resume more strenuous activities under a structured rehabilitation program, and full recovery may take up to 6 months.

When do I consult a hip specialist?

FAI is a condition that intensifies slowly over time, as symptoms are ignored the amount of damage done to the hip joint is significant. Only a certified orthopaedic physician can accurately diagnose your condition and provide the best form of treatment. A specialist can also help you develop proper body mechanics that will preserve your joints for years to come.

If you believe you might have FAI, and conservative home treatments haven’t helped, schedule an appointment with Dr. Steve Hamilton for an evaluation and treatment plan personalized to you.