What Causes Femoroacetabular Impingement

Femiroacetabular impingement

Femoroacetabular impingement

Femiroacetabular also called as Hip Impingement. This is a condition where there is Mechanical or structural disorder in the hip.

In this condition, an extra bone grows along with the bones that form the hip joint, giving the hip an overall irregular shape. The bones do not fit properly together and hence the bones keep rubbing against each other during movements.

It can occur in all ages, from young adolescents and adults to elderly people.

PATHOLOGY

In a healthy hip, the femoral head or rounded end of the thigh bone fits perfectly into the hip socket in such a way that it can move and glide freely with the help of the lubrication of the synovial fluid present in the joint space.

The structure called Labrum that lines the rim of the hip socket provides stability as it helps to secure the femoral head firmly with it.

Therefore, an obstruction to this structure, like the overgrowths of the bone along the hip joint can cause irregularity in the structure thus preventing smooth, painless, and free movements, giving rise to a condition called HIP IMPINGEMENT.

CAUSES OF HIP IMPINGEMENT:

This condition can be caused due to a variety of reasons:

  1. It can be a birth defect where a child is born with such a structural defect
  2. It can also occur during the developmental process of the child
  3. Activities which require movements beyond normal range like sports e.g. football, basketball, etc.
  4. Trauma due to accidents
  5. Conditions like Perthes Disease called as Slipped femoral epiphysis

Types of Hip Impingement:

3 Types hip Impingement

 Three main types are:

  1. Cam impingement- occurs when the round end of the thigh bone is not perfectly round and prevents its smooth movements and attachment with the hip.
  2. Pincer impingement- involves excessive involvement of femoral head by acetabulum/ space on a hip that attaches with femur head.
  3. Combined Impingement- Both conditions can exist at the same time.

SYMPTOMS:

  1. Pain and stiffness in the thigh and hip
  2. Flexion of the hip is not possible beyond a point
  3. Pain in the groin area after flexion of the hip eg running or jumping
  4. Pain occurring at rest, at the hip, thing and the groin, as well as during activity.

DIAGNOSIS:

To acquire a thorough diagnosis of this condition, medical examination including the patient’s history and physical examination, with the assessment of the motions the patient can carry out.

Comprehensive diagnostic evaluation includes:

  1. Radiography of hip joint
  2. MRI IN 3-D
  3. CT scan

All these investigations are sufficient to arrive at the diagnosis of hip impingement and after the accurate diagnosis, the treatment plan is carried out.

TREATMENT:

This includes aiming at the Joint Preservation, Resurfacing, and Replacement with appropriate treatment options.

Conservative methods like:

  • Reducing certain types of physical activity like extensive exercise or sports
  • Physiotherapy
  • Pain management
  • Injections for reduction of pain

Surgical intervention is required when the conservative methods fail to correct the condition, which is possible in some cases.

But in advanced conditions, and arthroscopic surgery is most commonly recommended and performed, which is successful in treating most of the cases.

But an Open surgery can also be indicated in cases where severe deformity has taken place and requires to perform “Bone-cutting” of the extra bony growths, and the realignment of the joint.

In an abnormally shaped femoral head or hip socket, reshaping is done with osteoplasty or debridement procedure.

Post-op recovery completely depends on the severity and the procedure done and can take up to several months for unrestricted and free mobility to occur.

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