CONDITIONS

HIP

FEMORAL ACETABULAR IMPINGEMENT

OVERVIEW

Your hip is the joint where your thigh bone meets your pelvis. The hip is a ball-and-socket joint made up of the acetabulum and the femoral head, which is the upper end of the femur. Articular cartilage over the ball and the socket allow the bones within the joint to glide over one another smoothly.

In a healthy hip, the femoral head fits perfectly into the acetabulum. But an ill-fitting joint will cause friction leading to femoroacetabular impingement. The joint may be ill-fitting if the bone overgrows or bone spurs develop within the hip joint, or if the femoral head is not round. In some cases, both these impingements are present.

CAUSE

An ill-fitting hip joint usually develops in the growth phase during childhood. When this ball-and-socket joint doesn't fit correctly, over time, it leads to joint damage and pain diagnosed as femoroacetabular impingement.

SYMPTOMS

While many people with hip impingements go on to live their lives with few symptoms, others may experience painful symptoms as a result of damage to the cartilage or labrum, and the disease is likely to get worse.

Symptoms include:

  • A dull ache or pain near the inner hip, or groin area, usually after walking, or prolonged sitting.
  • A locking or catching sensation of the hip joint
  • Difficulty walking
  • Pain in the lower back, the buttock, or the side of the hip

TREATMENT

Non-surgical treatment of hip impingement or femoral acetabular impingement usually involves rest, anti-inflammatory drugs and pain medications. Physical therapy can also be done to improve the range of motion in your hip and strengthen muscles surrounding the hip joint.

In cases where symptoms are not alleviated by a conservative approach, and the MRI scan shows that the hip joint has been damaged, Dr Pienaar may advise surgery. In such cases, arthroscopic surgery may be done using small incisions and thin instruments. During arthroscopy, your surgeon inserts an arthroscope through a small incision. This arthroscopy is fitted with a camera to allow Dr Pienaar to visualise the internal joint on a monitor, while other surgical instruments are inserted through separate incisions to remove bony spurs or bumps, repair the damaged labrum and articular cartilage in the joint.  In some cases, this may require open surgery.

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