Hip Impingement
Hip impingement is a bothersome condition where the hip bones do not go together smoothly and they rub against one another. There are three types of this condition: Pincer, Cam, and Combined. Hip impingement occurs when the developing structures don’t form properly during childhood. The symptoms include pain, stiffness, and limited range of motion. Treatment for this condition involves arthroscopic surgery for repair of the damaged joint or, in severe cases, hip replacement surgery.
What is Hip Impingement?
Hip Impingement, known as femoroacetabular impingement (FAI) to doctors, is a condition where the bones of the hip are not normally shaped. The hip bones do not fit together correctly so they rub against each other, causing damage to the joint.
The hip is a type of ‘ball-and-socket’ joint. The acetabulum-which is part of the pelvic bone-helps form the socket. The ball is the head of the femur bone, which is the upper portion of the thigh bone. There is a slippery tissue known as the articular cartilage that covers the surface of this ball-and-socket to create a low-friction, smooth surface that allows these bones to glide easily across each other. With hip impingement, bone spurs form around the head of the femur and along the acetabulum, causing the hip bones to hit against each other rather than glide smoothly along. This can result in tears and breakdown to the cartilage and joint structures, creating the condition of osteoarthritis.
What are the Types of Hip Impingement?
There are basically three different types of femoroacetabular impingement or hip impingment. The first type is called Pincer. The pincer type occurs because extra bone sticks out over the normal rim of the acetabulum and the joint area structures become crushed under this prominent rim.
The second type is known as Cam. With this type of impingement, the femoral head is not round and cannot smoothly rotate inside the joint as it should. A bump forms along the edge of the femur head and this grinds the cartilage that is inside the joint area.
The third type of femoroacetabular impingement is called Combined. Combined impingement simply means that both Pincer and Cam types of damage are present.
What is the Cause of Hip Impingement?
Some people can live long, active lives with this condition and never have limitations or complications. Others, however, develop symptoms that may include stiffness, pain, and limping. This occurs when there is significant damage to the cartilage and the disease progresses or worsens. Hip impingement occurs because the hip bones do not form adequately during the childhood growing period. The joint damage is the result of a deformity of a cam bone spur or a pincer bone spur, or both, that causes the joint damage and the femoroacetabular impingement.
What are the Symptoms of Hip Impingement?
Many people have hip impingement for years and do not even know this because it is not usually painful in the early stages. The orthopedic specialist will refer to it as ‘Hip Impingement Syndrome’ when symptoms develop. These include stiffness in the groin or front part of the thigh and loss of range of motion of the hip joint. During the early stages, you may only have pain when you move the hip near its motion limits but as this condition progresses, you start to feel pain with more subtle activities. These include sitting for long periods of time or walking up hills.
What is the Treatment for Hip Impingement?
There are many things your orthopedic specialist will recommend, like rest, modification of activities, exercise, and use of anti-inflammatory and pain medications. If these treatments do not work for you, the surgeon may recommend hip impingement surgery, a common procedure.
The type of surgery really depends on the extent of your impingement and how much of your cartilage is damaged. Often, the doctor can perform surgery by means of arthroscope. This is known as arthroscopic surgery and this technique involves the use of a lighted scope that goes into the joint through tiny incisions. The doctor can visualize the inside of your hip on a TV monitor and repair damage and improve your range of motion. If you have severe damage, hip replacement surgery may be necessary to improve function and limit pain and stiffness.
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