Before we discuss what hip or femoral/acetabular impingement is, we need to understand the anatomy of the hip joint.
Anatomy of the hip joint
The hip joint is a ball and socket type joint. The ball refers to the head of the femur, also called the thigh bone, whereas the socket is the acetabulum, a special grooved part of the bone within the pelvis. The femoral head fits neatly into the socket. A ball and socket joint allows forward and backward movement plus side to side. It also allows internal and external rotation. Alongside these two bones is cartilage which helps to stabilize and facilitate hip movement.
This cartilage is split into two types;
Articular cartilage lines both the femoral head and the acetabulum (the cup). This cartilage is a strong and slippery material which allows the two surfaces to glide against each other during movement.
Labrum cartilage is around the outside edge of the acetabular. This cartilage acts as a cushion and also acts like a rubber seal to keep the femoral head in place.
So, by understanding hip anatomy, we can now look at how hip impingement occurs and the effect it can cause.
What are the types of impingement?
Doctors tend to talk of two main types, plus a combination of the two. The first one is cam impingement. This occurs when the femoral head (the ball) is not smooth and perfectly round. This interferes with the femoral head’s ability to move smoothly within the socket. Secondly we have pincer impingement. This is where there is excessive coverage of the femoral head by the acetabulum. This means that during hip flexion, the neck of the femur bone bumps and catches on the socket rim. This will result in cartilage and labral damage.
As mentioned, both conditions can be present at the same time. This is referred to as combined impingement.
Causes and symptoms of hip impingement
A common cause is osteoarthritis whereby the joint suffers “wear and tear”. Also known as degenerative joint disease, it is estimated to affect over 32.5 million people in the USA (statistics from the Center for Disease Control and Prevention). Other people at risk of impingement syndrome are athletes who are involved in high-level sport. Also, those who have a history of sports-related trauma to the hip.
Initially, many people may not notice any symptoms but over time as the joint deteriorates then problems occur. The commonest being pain as the two bones start to grate against each other. This may be a sharp or dull pain, sometimes felt in the back or pelvis. Clicking and locking of the joint may also occur.
What are the treatment options?
The first course of action should always be conservative. This may be anti-inflammatory medication. It may also be a modification of your activity level. Cortisone injections may help some too.
If the damage to the joint is severe then surgical intervention may be necessary. You may need to look at what surgery will be beneficial to you.
One option is arthroscopic surgery for femoral/acetabular impingement, aka hip arthroscopy. This refers to a type of keyhole surgery. It’s where the surgeon uses an arthroscope, which has a camera lens and light at the end of it. This allows good visualization within the joint using only a small ¼ inch incision. Once they can see where the damaged area is they can use other fine instrumentation via a 2nd and 3rd portal. They can then trim away or smooth down where necessary. This surgery is minimally invasive as it’s done through small incisions, leaving very little damage to muscle and tissues.
You will expect to go home the same day after hip impingement surgery. You will be given advice re pain relief post-operatively, and also physical therapy. It may be necessary to look at your lifestyle regarding work and sports activities. The success of post-operative movement and pain relief is high, with the results much improved over recent years.
Hip arthroscopy Miami – South Florida International Orthopaedics
If you or someone you know is suffering from hip pain, get it investigated. It may be impingement. Seek a consultation and get a diagnosis at our South Florida orthopedic center.
Depending on where you live, and if surgery is required then you want to find an expert in that field. In South Florida there is a team of orthopedic surgeons. We specialize not only in hip arthroscopy and impingement surgery in Miami, but also in general orthopedic surgery, sports medicine, musculoskeletal conditions and more. This is a group of highly-rated orthopedic surgeons who specialize in minimally invasive surgery, and the latest innovative non-surgical treatments. Our goal is to provide you with high-level care that is individually fitted to your needs and lifestyle. We offer a variety of surgical, non-surgical and regenerative treatment options for our patients. For your convenience, our orthopedic doctors are available at 2 clinic locations:
- Miami office: 9165 S.W. 87th Avenue; phone# (305) 233-0011;
- Homestead office: 925 NE 30th Terrace, Suite 102; phone# (305) 247-1701
To learn more about our services, including hip impingement surgery in Miami, please visit our website.
The material contained on this site is for informational purposes only and DOES NOT CONSTITUTE THE PROVIDING OF MEDICAL ADVICE, and is not intended to be a substitute for independent professional medical judgment, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions or concerns you may have regarding your health.