1. Hip Impingement is not the same as shoulder impingement.
Hip impingement is a relatively new concept in the orthopedic literature. It is officially termed femoroacetabular impingement (FAI). It occurs when the proximal part of the hip (femur) impinges on the socket (acetabulum). This can cause pain, especially with extremes of hip positions, or even with something as common as sitting.
2. Hip impingement can be related to cam or pincer lesions.
Cam lesions are prominences or bumps on the femoral neck. This causes decreased motion of the hip before it hits up against the pelvis. A pincer lesion is located on the acetabular side of the hip. This may push on the labrum from underneath and cause labral tears. Often, there are cam-and-pincer, or mixed-type lesions, where the labrum gets crushed between these two lesions. These may not cause hip pain except for certain positions. Athletes may notice these problems more often because they place their hips in more extreme positions. This may include soccer players, figure skaters and hockey players.
3. Some cases may be treated without surgery.
Physical therapy can increase your flexibility and strength. Strengthening of the core muscles and hip muscles can protect the joint. Anti-inflammatory medications can help relieve acute injuries.
4. Some cases may need surgery.
If nonsurgical treatments fail, surgical options are available. Shaving and reshaping the femoral neck and head (osteochondroplasty) can reduce the cam lesions and increase the range of motion before getting impingement. Trimming and repairing the labrum can restore the function of the labrum, which is to protect the articular cartilage. Traditionally, this is open surgery with an incision on the lateral hip. Cutting the greater trochanter (osteotomy) is necessary. The greater trochanter is the bump on the lateral portion of your hip that you can feel. After the procedure is completed, the greater trochanter is reattached with screws.
5. Hip arthroscopy is a new way of treating these disorders.
Hip arthroscopy is performed through two or three 1-cm incisions around the hip. It has the advantages of not having to cut the bone to access the hip. Using a burr, the femoral neck is able to be reshaped and the hip is able to be taken through a series of movements to make sure that there is no further impingement. Labral tears are able to be repaired through the scope as well. This is an outpatient or overnight-stay procedure.
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