Your hips play an important role in walking and transferring the force and weight of the upper body to the pelvis down to the legs. When something happens in one or both of the hip joints it can cause significant pain, impede your natural range of motion and have a severe effect on your overall quality of life. A condition known as hip impingement can affect the performance and range of motion of your hip joints.
What Is A Hip Impingement?
A femoroacetabular impingement or FAI is commonly referred to as a “Hip Impingement.” It occurs when the ball of the femoral head pinches up against the acetabulum cup of the hip joint in the pelvis. In many of these cases, the labrum and cartilage of the hip can also be damaged. This can cause hip stiffness and pain. Left untreated it can also put the individual at increased risk of arthritis in the hip joint.
The Different Types Of Hip Impingement
Hip impingements can be broken down into two different categories based on symptoms, severity, and the tissues that are affected.
A Deformed Femoral Head
The first type of hip impingement is caused by a deformity in the ball of the femoral head. With this type of impingement, the ball itself has more of an oval shape rather than a rounded one. The way the deformed head contacts the cup of the hip joint in the pelvis creates excessive friction. As time goes on this can wear down the cartilage that cushions the joint, as well as lead to increasing discomfort caused by inflammation. Left unaddressed this type of hip impingement can put the individual at increased risk for arthritis.
The second type of hip impingement is caused by an abnormally shaped cup in the pelvis portion of the hip joint. When his acetabulum is deformed it covers too much of the femoral head which increases the friction at the edge where the cup connects with it. This can cause pain, swelling, and recurring complications from chronic inflammation.
Can You Have Both Types Of Hip Impingement?
While it’s rare, an individual can have both types of hip impingement at the same time. Though this can severely affect mobility, cause inflammation, and put the person at high risk for developing arthritis complications.
What Are The Common Symptoms Of Hip Impingement?
Most individuals with hip impingement will experience some or all of the following symptoms.
- Pain near the groin or front of the thigh
- Stiffness in the groin front of the thigh
- Increased discomfort when bending up at the hip
- Discomfort when bending at the waist
These symptoms might start out minor at first and are more likely to occur during common everyday activities such as riding a bike, tying shoes, or sitting for an extended period of time.
What Are The Increased Risk Factors For Hip Impingement?
Most people with a hip impingement have had the deformity in either the femoral head or the cup of the hip joint since birth. It’s typically something that their pediatrician noticed and has been tracked throughout their lives.
Though these abnormalities can develop over time. Especially in young athletes that participate in contact sports and athletics that involve a lot of twisting of the hip and squatting. It’s also possible for other medical conditions such as slipped capital femoral epiphysis to cause this abnormal shape.
How Is A Hip Impingement Diagnosed?
A hip impingement that is due to genetic factors or abnormalities found at birth is generally tracked throughout an individual’s life. In these cases, the onset of symptoms generally isn’t a surprise. Though hip impingements that are caused by an injury or athletics can also develop over time.
The process of diagnosing a hip impingement starts with evaluating the patient’s medical history, this is then followed with a physical exam. If the physician finds concerns or potential for an existing hip impingement they will likely refer you for an MRI or take some X-rays to assess the state of the femoral head and the cup of the hip joint.
An MRI scan is typically required to evaluate the soft tissues in the hip as well as the impact on other surrounding structures. It might also be needed if there are concerns about arthritis or severe inflammation in the hip that influences the clarity of an X-ray.
How Is A Hip Impingement Treated?
Many hip impingement treatment plans are non-surgical. The goal is often to help reduce inflammation and improve the range of motion. This might involve things like rest, activity modification, anti-inflammatory medications. When combined with professional physical therapy these strategies can help manage symptoms without the need for surgery.
If these methods don’t yield measurable improvement or your range of motion is severely affected, your physician might recommend surgical intervention.
Surgical Treatment For A Hip Impingement
Hip impingement surgery generally has two objectives. It starts with addressing the damaged or deformed portion of the hip joint. To do this, your physician may have to remove or repair the damaged tissues.
The second objective is to correct or improve the abnormal shape of the hip joint. This might involve arthroscopically removing some of the bone tissue from the femoral head or the cup of the pelvis in the hip joint.
To do this your physician will make a series of small incisions to gain access to the deeper regions of the hip joint. At that point, narrow, precise instruments and a special camera will be used to look inside the hip joint. Minor modifications are then made to the abnormal areas to edit them and improve the relationship between the femoral head and the cup of the acetabulum.
In a more severe case, where significant edits need to be made to the hip joint, or a more substantial amount of tissue needs to be addressed. Your physician might recommend a more open procedure, that involves larger incision sites In many of these cases a two to four-day hospital stay is required and you might need to use crutches for six to eight weeks.
How Long Does It Take To Recover After Hip Impingement Surgery?
The recovery time after hip impingement surgery will vary based on the extent of the procedure. For a minor arthroscopic procedure, six to eight weeks is a realistic time frame and may be influenced by physical therapy and other health factors.
In the case of an open procedure, where your physician needs to remove a significant amount of tissue from the affected joint, the recovery time could take between 4 to 6 months.