Contact us
To receive personalized attention
What is Femoroacetabular Impingement Treatment?
The pathology of femoroacetabular impingement is due to an alteration in the shape of the hip joint that can occur in the head of the femur, in the acetabulum or in both places, creating abnormal, painful and premature wear and tear on the joint. It generally occurs at the extremes of flexion mobility and internal rotation.
It is prevalent in sports such as soccer, volleyball, tennis, basketball, flag, runners, cyclists, or any sport that involves quick changes of direction.
It is a mild pain that occurs at the end of the activity, it remains present although it is not disabling, so it usually goes unnoticed and thus allows the constant evolution of the pathology.
This pathology arises without an apparent cause, it could be said that it can form during the patient’s growth, however, it is not yet known for sure what can cause it.
Sometimes, due to its symptoms, femoroacetabular impingement is confused by other branches of medicine with inguinal hernias, sprains, tendinopathies, among others. However, today this pathology is considered a major cause of hip osteoarthritis.
With the constant wear and tear it causes in the joint, osteoarthritis can occur in the patient, who would need a hip replacement at premature ages, which is why hip joint preservation treatment is so important to preserve the cartilage for longer.
What are the symptoms?
This pathology goes unnoticed for a while, when it begins to form it is imperceptible, as the changes within the joint increase and there is a pinch in some tissue is where the pain appears. The pain of femoroacetabular impingement is characterized by presenting in the groin or buttock of the patient, specifically in some movements that can be rotation, flexion, etc.
During rest the discomfort disappears.
As the disease progresses, the hip begins to lose the ability to move, physical activities cause discomfort, including walking, and at some point there is a blockage of the joint. It is important to consult a specialist when we feel pain, even if it is weak but prolonged, in our joint. If after playing sports, running or walking you begin to feel discomfort and this condition has been with you for a little more than a week, then it is time to check with an orthopedic doctor.
What are the causes of femoroacetabular impingement?
It is a multifactorial condition, which means that it can be caused by various factors that so far cannot be clearly defined, however we will mention some reasons that can be causes of this damage to the hip.
- Genetic predisposition, in some cases this morphology accompanies the patient from birth.
- Stress, although it is hard to believe, studies admit that the sports stress of growing young people can produce a bone adaptation in the coxofemoral area, this can trigger morphologies that collide with each other that cause impingement.
- Hip dysplasia can also be a likely cause for the condition.
- Poorly consolidated surgeries for femoral neck fractures.
- Pelvic and hip surgeries in the same situation as above.
- Sports that require a continuous rotation and flexion movement such as hockey, baseball, basketball, and/or soccer.
How to prevent femoroacetabular impingement?
Although science wants to find a valid preventive method, so far it is not possible, since it is due to the characteristics of each individual in the morphology of the femur and acetabulum. What can be recommended to prevent suffering from this condition are actions typical of mobility, which ensure a reduction in risk but not total prevention.
Regarding movements, it can be recommended to maintain good flexibility in the hip area, this is achieved with constant stretching exercise that allows the muscles and tendons to remain strong and with a high capacity for movement. Exercises such as yoga, dancing and pilates are activities that promote this flexibility. On the other hand, if the patient knows their genetic history of this pathology, they may prefer to practice low-impact sports such as swimming, and reduce or avoid high-impact sports.
Maintaining a constant review of your physical condition can also be a good strategy to prevent the advance of impingement, that is, when you present pain, discomfort or an unexpected injury, go to the specialist doctor to comply with a treatment that ensures your long-term health.
How is this pathology diagnosed?
When you go to a doctor’s office from an orthopedic specialist, you will most commonly receive prior attention of questions so that the doctor has a medical history base that will help diagnose your situation.
Subsequently, the doctor proceeds to perform physical examinations to determine if it is indeed a pinch. This test is called the “Impingement Test” It consists of checking if there is pain in the groin or buttock during the flexion or twisting of the hip promoted by the specialist.
In the event of pain appearing, the doctor has a previous diagnosis, however, other tests are used to prove the diagnosis, he may recommend X-rays or MRI to verify the condition through images of the patient’s body.
Once your trusted doctor finds the final diagnosis, he will let you know your situation and present you with the appropriate treatments for your joint.
What is the treatment for femoroacetabular impingement?
Nowadays a procedure called hip arthroscopy is performed, which is a minimally invasive procedure, is less traumatic for the patient and for the joint, is painless and allows a quick recovery.
With this treatment, what is done is surgery with small incisions, which allows the evaluation and modification of the joint by means of an arthroscope that reconstructs any alteration of the joint that causes wear and tear.
Types of femoroacetabular impingement treatment
Conservative treatment
It is recommended to certain types of patients, it involves the use of physiotherapy and anti-inflammatory drugs. It is ideal for people who are not so affected by the situation, that is, when they have an early diagnosis.
Injections that reduce pain for a period of time can also be used. During rehabilitation, parameters of appropriate uses of the hip are established in order to prevent the injury from reappearing.
It is considered as the first step, where the orthopedic doctor can confirm the cause of the ailment and determine if more incisive treatment is necessary.
Surgical treatment
Within this treatment there are two options that will depend on the need of each patient. Your orthopedic doctor will recommend the one that he or she considers most appropriate and that gives you the best results.
If you are looking for an orthopedic hip specialist in Panama you can count on Dr. José Felix Castillo, he is committed to offering effective solutions for your ailments
What is hip arthroscopy?
Hip arthroscopy uses a combined anaesthesia, i.e. epidural anaesthesia, to relax the hip muscles and joints to be treated and general anaesthesia to monitor the patient during surgery.
The leg is placed in the proper position, with a process called traction, to achieve the necessary space to insert the surgical equipment.
At least two or three incisions of one or two centimeters are made, in one of these incisions a camera is inserted and in the others the surgical equipment that helps the surgeon to mold the joint and eliminate the alterations of the joint.
This process can be completed in approximately two hours and provides a great advantage of recovery and long-term functionality since the patient, as the necessary recovery time passes, will be able to have their normal lifestyle.
The goal of this treatment is to correct the alteration in the shape of the hip joint in a way that gives the patient a speedy recovery and can return to daily activities as soon as possible
Arthroplasty or total hip replacement
Femoroacetabular impingement, when not treated in time, can cause accelerated wear of the cartilage, in these cases it is not possible to perform a repair and the joint must be replaced with a prosthesis.
By placing the prosthesis, the recovery of quality of life is ensured, however, it is necessary to consider the complexity of the surgery and the recovery time that the patient must estimate to incorporate mobility into their daily routine.
The cases that most recommend this treatment are in people over 50 years of age who have more advanced wear and tear.
Considerations before this surgery.
Avoid self-medication with drugs or natural products, vitamin supplements that can alter the patient’s coagulation. Discontinue the consumption of these supplements, drugs and/or natural products seven days before surgery. Do not drink alcoholic beverages and if you smoke, eliminate or reduce consumption.
Types of hip impingement or pinching
Cam-type femoroacetabular impingement
It is identified by the imperfect growth of the head of the femur that connects to the hip pelvis, it can form in different ways and eventually collide with the other bone and cause pinching.
It is a common condition that is diagnosed mostly in adolescents and young men under the age of 30. In the same way, it can be seen after a traumatic injury to the hip.
Pincer-type femoroacetabular impingement
It differs from the previous one because the affection or imperfection occurs at the acetabular border, that is, the rim of the acetabulum becomes narrower and causes an overcoverage of the head of the femur that finally causes impingement.
This type of injury is common in women in their 40s and older.
Femoroacetabular impingement of the mixed type
It is the combination of the two previous conditions, the patient presents an exaggerated growth of both parts complicating or limiting the mobility of their joint.