Hip Arthroscopy

FAI and Hip Arthroscopy Background Information

There is an expanding awareness in the orthopedic community of a previously undiagnosed hip condition known as FAI, or Femoroacetabular Impingement. Hip pain was previously thought to be a problem primarily affecting individuals age 50 and over. But with the growing awareness of FAI, we’re discovering hip pain in young teens and younger adults. Hip arthroscopy, a surgical treatment for this condition, is rapidly gaining attention and proving to be very effective in relieving hip pain in those diagnosed with FAI.

With less than a dozen surgeons in the United States performing this procedure, The Orthopedic Specialty Hospital (TOSH) is be one of the few facilities scheduling arthroscopic surgery on the hip for the treatment of FAI.

Dr. Hugh West, the orthopedic surgeon performing this procedure, comments:

“It is exciting to be part of the evolution of our understanding of how to best treat this relatively recently understood condition.”

Femoroacetabular Impingement (FAI)

Femoroacetabular Impingement (also spelled Femoral Acetabular Impingement) affects active individuals including teenagers, young adults, and middle-aged adults. The pain from FAI sometimes begins with an injury or accident, but it often simply appears during activities like running, dancing, or other athletic activities. This pain can be temporarily relieved through inactivity or rest, only to flare up again when physical activity resumes.

Symptoms of FAI can include:

  • hip pain when standing and walking after sitting for a long period of time
  • tightness or "popping" in the groin area or the front of the pelvis
  • limited range of motion in the hip
  • increased pain when participating in sports or physical activities

Femoroacetabular Impingement is a mechanical mismatch between the “ball” and the “socket” of the hip. There are two types of impingements:

  • a Cam deformity: an extra bony growth on the surface of the femoral head
  • a Pincer deformity: an overdeep Acetabulum (socket) that restricts the movement of the femoral head

The Cam and Pincer forms of FAI can exist together, which is called "mixed impingement". FAI is a possible precursor to osteoarthritis of the hip and is also associated with cartilage damage, labral tears and hyperlaxity.

Due to the fact that FAI is relatively unknown and was only recently recognized as a legitimate condition, it is often misdiagnosed as bursitis, back pain, or sports hernia.

Diagnosing FAI

MRI’s and 3-D CT scans are effective imaging tools used when diagnosing FAI. The MRI can confirm injuries to the labrum, and the 3-D CT scan can provide valuable surgical information on both the Cam and Pincer deformities.

While diagnostic techniques continue to improve, the physical exam to identify painful trigger points or positions can also help in diagnosing FAI.

For more information, visit the FAI (Femoroacetabular Impingement) tab under Patient Resources.

About Hip Arthroscopy Surgery

The hip joint is the last large joint to be addressed with minimally invasive techniques such as arthroscopy. During the hip arthroscopy surgery, the surgeon opens up the joint space in order to improve access to the damage within the joint. Through 2-3 small portals, the surgeon inserts a small camera to assist in identifying and repairing the Labral damage and then reshapes the ball and socket to create a better “fit”. Most hip arthroscopy procedures take between 2 and 3 hours, depending on the extent of the damage to the hip.

Arthroscopic surgery has been used for many years in the knees and shoulders; however, hip arthroscopy is a newer technique and is part of a hip preservation program offered at The Orthopedic Specialty Hospital.

By offering hip arthroscopy, Dr. West aims to slow down or alter the natural course of hip pain, so that undergoing a total hip replacement becomes unnecessary. Hip arthroscopy is proving very successful for the treatment of FAI. It generally allows individuals to return to their active lifestyles within 4-6 months after surgery.

Hip Arthroscopy Surgery Recovery

You will be up on crutches within the first 24 hours after surgery. Depending on the actual surgical procedure, crutches may be required for the first 2-4 weeks. Rehabilitation with a qualified and experienced physical therapist is an essential part of a patient's recovery.

Returning to all activities may take 4-6 months, during which time the physical therapist will continue to work on increasing your core strength and restoring your hip's range of motion. Returning to sedentary work or activities can resume 7-10 days post-operatively, and you can stop using crutches when you are able to walk without limping.

“It is very gratifying to see how much impact this treatment can have on one's quality of life. TOSH has a very complete program for diagnosing and treating this problem.”
     - Dr. Hugh West, Orthopedic Surgeon

For further information, individuals may call TOSH in Murray, Utah at 801-314-4900 and ask to speak with Janet Pugh or Diane Daley.

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