Femoroacetabular impingement (FAI) is a condition in which the extra bone grows along one or both bones that form the hip joint – making the bones abnormal. Because they are not perfectly aligned, the bones rub each other during movement. Over time this friction can damage the joint, causing pain and reducing activity.
Normally, the hip joint (femoral head) sits on the femoral head neck similar to ice cream sitting on a cone. Compression and friction occur when the female head and neck come into contact with the socket (acetabulum), causing damage to the hip joint.
Pinching or friction can cause damage to the labrum (cartilage with fibers that line the outer edge of the socket) or articular cartilage (a white covering over the skeletal surfaces that causes a very smooth jump surface of the joint).
Types of Femoroacetabular impingement
Cam impingement; Because the head and neck are not properly aligned, motions such as deep curves and internal rotations can erode the cartilage from the bone marrow or tear the labia. This can cause pain and wear to the hip joint. It is called cam impingement because the head bone of the thigh and neck has a bone marrow that protrudes like a camera used in rotating machines.
Pincer impingement; Pincer insertion is characterized by a bone hanging at the edge of the acetabulum. This type of insertion got its name from the labrum compression between the neck of the thigh and the head and the extra bone of the acetabulum. This can lead to labral tears and eventually lead to pain and wear of the hip joint.
Combined; Patients may have cam and pincer impingement at the same time.
What to Know about Hip Impingement
Hip inclination, or Femoroacetabular impingement (FAI), occurs when the thigh bone head (hip ball) presses against the acetabulum (hip cup). When this happens, damage to the labrum (cartilage surrounding the acetabulum) can occur, causing hip stiffness and pain, and can lead to arthritis.
Types of hip impingement
In most living adults, hip replacement is caused by abnormal bone growth. Abnormal growths can occur near the femoral head, acetabulum, or both. The location of abnormal growth determines what type of impulses occur:
1. Cam. Cam infiltration occurs when a large bone grows on the edge of the female head, where it meets a part of the femur called the femoral neck. Excessive bone growth forms a nodule, which can cause one or both of the following:
- Prevent the femoral head from fully rotating in its socket.
- Rub against the cartilage located inside the hip’s socket, causing damage to the cartilage.
- Cam impingement is most common in young men.
2. Pincer. Pincer insertion occurs when a large bone grows on the edge of the hip joint. Extra bone forms an overhang, making the socket too deep in some areas. Many bone tissues can
- Prevent the femoral head from rotating in its socket.
- Cause the hip’s labrum to become pinched.
- Pincer impingement tends to be most common in middle-aged women.
3. Combined. Most people have cam and pincer hip impingement.
The doctor may use medical imaging to determine the type of hip pain a patient has.
Who is at risk?
FAI is common for high-level athletes, but it also occurs in working people. Although any type of aggression can occur in men or women at any age, the Cam replacement type often affects men in their 20s, while Pincer tends to occur more frequently in women in their 30s and 40s who participate in athletics. . .
FAI-related sports include the arts of karate, ballet, cycling, rowing, golf, tennis, soccer, football, ice hockey, baseball, lacrosse, hockey, rugby, water polo, and squatting activities. in depth such as lifting force.
Symptoms of femoral acetabular impingement
Symptoms of hip insufficiency, including hip pain and decreased range of motion, are described in detail below. People who experience severe hip pain and people who have moderate to moderate hip pain lasting more than a few weeks are encouraged to consult a medical professional.
- Frequent pain in or near the hip and groin. This pain will come and go with some activity. Over time, the pain may increase from time to time.
- Severe pain in the groin after certain movements
- Mild pain in the hip or groin at rest
- Loss of maximum movement, especially when rotating the hips inwards or moving the leg toward the center of the body.
- Hardness around the hip, making movements slower or harder.
- Problem climbing stairs. Changes in hip flexibility can change a person’s natural motion during climbing stairs.
- Decreased muscle strength around the hip.
- Loss of balance. Balancing on the affected leg can be more difficult than balancing on the affected leg.
- Chewing. In moderate to severe hip conditions, hip pain and other symptoms can cause a person to walk and relax.
A person with hips may have one, some or all of these painful symptoms. For example, one person may experience recurrent pain during exercise and during voting. Another may only feel intense pain after a long walk.
Causes of femoral acetabular impingement
The hip joint is a ball-and-socket joint that connects the femur to the pelvis. People with FAI have an abnormal position on the ball (above the thigh bone) or socket (groove on the hip bone). The abnormal condition causes friction during movement and can damage the cartilage and the rotating labrum (cartilage that encloses the hip joint).
The most common misdiagnosis associated with FAI usually occurs at birth. But they can also grow later in life, especially during adolescence. Doctors classify FAI into one of three categories based on factors:
- Cam; This type is the result of bone growth in the femoral head. In some cases, physical activity may cause this growth to occur.
- Pincer; Caused by excessive bone growth in the hip joint, this growth often occurs during the development of the baby.
- Combined; Both FAI cam and pincer types are available.
People with physical activity may experience pain from FAI sooner than people who are inactive. But in most cases, practice does not lead to FAI.
FAI occurs because the hip bones are not normally formed during the formative years of childhood. It is a deformity of the cam bone spur, pincer bone spur, or both, which causes joint damage and pain. While the hip bones are irregular in shape, there is little that can be done to prevent FAI.
It is unknown at this time what he will do after leaving the post. Some people can live a long, active life with FAI and never have problems. When symptoms occur, however, they usually indicate that there is damage to the cartilage or labrum and the disease can progress.
Because athletes can perform hip joint work more efficiently, they may begin to experience pain sooner than those with little or no work. However, practice does not cause FAI.
Diagnosis
If you have symptoms of hip impingement, your doctor may diagnose the problem based on your description of your symptoms, physical examination, and imaging results. These experiments may include one or more of the following:
X-ray; a test that provides images of interior designs on film. X-rays may show defects in the shape of a ball or in the upper part of the thigh bone or extra bone around the socket.
Magnetic resonance imaging; (MRI), a procedure that uses large magnets, radio waves, and computers to produce detailed images of tissue inside the body. MRI may show fraying or tearing of cartilage, including those running along the socket (labrum).
CT scan; a technique that combines special X-ray equipment with modern computers to produce multiple images or images within the body. These images can be scanned, printed, or transferred to a CD. A CT or MRI scan can help your doctor determine if you need surgery.
Cortisone injections; The doctor may recommend injecting cortisone directly into the hip joint to help confirm the diagnosis. If the injection alleviates the patient’s pain, it indicates that the pain is caused by a problem inside the hip joint, such as infiltration, and not outside the hip capsule, such as piriformis disease.
There are many conditions that can cause hip pain. In addition to hip replacement, these conditions include but are not limited to hip osteoarthritis, muscle problems, hip bursitis, and joint infections, as well as pelvic conditions and back problems that can cause hip pain.
Treatment of femoral acetabular impingement
When a person is diagnosed with a hip replacement, the doctor will recommend treatment options. These options usually include non-surgical treatment, with an emphasis on physical therapy, and surgery.
1. Arthroscopy
This is done through small incisions in the skin to allow the camera to see the structures inside the hips. This can address the labrum, deformity of the femoral head or an abnormally shaped acetabulum.
This is usually done by a U-M surgeon who specializes in sports injuries or has formal hip arthroscopy training. Patients with rheumatoid arthritis are usually NOT candidates for hip arthroscopy. Labrum can either be damaged or repaired. This is determined by the quality of the labrum and the size of the tears as well as the type of disability.
2. Hip replacement
Total hip replacement is performed by a surgeon who specializes in hip replacement. This surgical procedure removes the head of the femur, neck and cartilage. The bone is then replaced with metal, plastic or ceramic bearing surfaces. This procedure is performed when the Femoroacetabular impingement has caused severe cartilage damage to the femoral head and acetabulum.
This is a clear procedure with an incision; does not occur under arthroscopy. Total hip replacement may be the first option procedure or the recovery procedure when the initial maximum or clear separation has failed. It has very lasting results and is over 20 years old and is performed on young patients through non-invasive techniques, which allow for early recovery.
3. Surgery
Surgery is usually recommended to correct hip joint. Exactly what type of procedure will be performed will depend on what causes the hip insertion and what type of soft tissue damage, if any, has occurred.
The following are some examples of surgical procedures performed on the hip joint. More than one procedure can be performed during one surgery:
- Cutting and removing bone tissue that contributes to impingement, thereby expanding (reducing) space.
- Labral debridement, which involves removing dry edges and loose pieces of labrum.
- Labral repair, which may involve the formation of labral tears by reconnecting the labrum to the bone
Hip surgery is performed arthroscopically or with open incisions, depending on the procedure performed; patient anatomy; and the preference of the surgeon. Many doctors believe that surgery to correct hip replacement will prevent or delay the development of hip osteoarthritis.
4. Relax and rehabilitation
Thus, for those who have symptoms early treatment may involve rest and rehab, while those who have persistent symptoms, arthroscopic surgery may be needed. The long-term persistence of FAI has not been fully established, but there is ample evidence that it may be a major cause of early hip arthritis.
Home Remedies
When symptoms first appear, it is best to try and identify the activity or something you may have done that could cause pain. Sometimes, you can adjust your activities, allow your hip to relax, and see if the pain subsides. Anti-inflammatory drugs, such as ibuprofen and naproxen, may be helpful.
- Corticosteroids; These drugs reduce swelling in and around the hip joint. Doctors usually prescribe this treatment by injection.
- Non-steroidal anti-inflammatory drugs; This type of medication reduces inflammation and is taken in pill form.
- Physical therapy; Special exercises can help strengthen as well as improve mobility.
If your symptoms persist, you will need to see a doctor to determine the exact cause of your pain and offer treatment options. Chronic pain symptoms have not been treated, FAI can cause further damage to the hip.