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Femoroacetabular Impingement

Femoroacetabular Impingement or FAI is the medical condition affecting the hip joint, where an extra bone grows along either one or both the bones that make the hip joint. These bones tend to have an irregular shape due to this, which causes these bones not to fit together causing them to rub against each other during motion.

femoroacetabular-impingement-treatment-bangalore

This friction between the bones, over time causes joint damage, pain and limited activity.
These bone overgrowth or bone spurs that occur in FAI usually develop around the femoral head and along the acetabulum. There are 3 types of FAI:

  • Pincer: This occurs due to the bone overgrowth extending out over the acetabulum’s normal rim.
  • Cam: In this type, the femoral head is not round and rotation inside the acetabulum is not smooth. Femoral head develops a bump that grinds the cartilage inside the acetabulum.
  • Combined: this occurs when both the pincer and cam types occur.

Treatment

Non – Surgical Treatment
The doctors would recommend the following non-surgical treatment:

  • Changes in Activity: change in the daily routine and avoiding activities that can aggravate the symptoms.
  • Non-Steroidal Anti-Inflammatory Medications: like ibuprofen et al are prescribed to help in reducing pain and inflammation.
  • Physical Therapy: is recommended for the improvement of range of motion of the hip and also for strengthening the muscles around the joint, which in turn will help relieve the stress on the injured cartilage.

Surgical Treatment
Surgery is recommended by the doctor when the non-surgical treatment does not help reducing the symptoms. The doctors would go for either Hip Arthroscopic or Open Surgical Debridement, depending on a few factors.

Hip Arthroscopic Debridement
This technique will help in treating many of the FAI issues. This procedure is performed by first creating tiny incisions. A small camera also called Arthroscope is inserted into one of the incisions to get a good view of the damaged area. Flexible and thin instruments are then inserted through these incisions and guided to the damaged area using the arthroscope.
The doctor will then clean or repair the damage present in the labrum and the articular cartilage. The FAI is then corrected by trimming the Acetabulum’s bony rim and also shaving the femoral head’s bump.
In some cases of severe nature, the doctor might perform with bigger incisions.

 

                                           

Authored by Dr Banarji B.H - Shoulder Surgeon, Bangalore

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