Hip Anatomy
- Femur – the head and neck region of the femur
- Acetabulum – the socket portion of the pelvis
- Labrum – a thickened cartilage ring surrounding the acetabulum. It provides stability to the hip, as well as a seal around the head of the femur.
- Cartilage surfaces – the lining surface of the hip joint that allows smooth gliding of the joint.
What Is Hip Impingement?
Hip impingement is when there is abnormal contact between the femur and acetabulum during normal movements of the hip joint. This can be caused by an femoral head that is not perfectly round (Cam type impingement) or a acetabulum that is too deep (Pincer type impingement). Often both the head and the socket have slight abnormalities. This is called mixed type impingement.
What Causes A Labral Tear?
Hip labral tears are often caused by repetitive twisting or hip flexion motions in patients with hip impingement. Isolated labral tears in the hip are common and may not cause pain. Failure to recognize and treat the underlying abnormal anatomy can lead to continued pain and a poor outcome.
Who Is At Risk For Hip Impingement?
In general, young athletes involved in sports that require forceful and repetitive hip movements are at the greatest risk of hip impingement. However, patients of all ages can have hip impingement depending on their anatomy and activities.
What Are Some Symptoms Of Hip Impingement And Labral Tears?
The most common symptoms are deep, sharp hip and groin pain on the front of the hip. This is usually worsened with quick twisting movements, turning, and squatting, and be quite painful with prolonged sitting.
I Think I Have Hip Impingement. What Should I Do Next?
An evaluation by an experienced medical provided with experience in non-arthritis hip problems will be very helpful. In general, we recommend routine x-rays of the hip with a high-quality MRI if your provider feels it is warranted. Based upon these findings, as well as your exam, we sometimes recommend a CT scan (higher radiation than MRI or xray), as well as numbing injections in the hip for diagnostic purposes.
How Is Hip Impingement Treated?
Like most orthopedic conditions, a trial of rest, activity modification, and anti-inflammatory medication is recommended. Guided rehabilitation with an experienced therapist can often quiet down and eliminate many symptoms of hip impingement. Changes in body mechanics and flexibility can be extremely helpful. If conservative treatment is not helpful and your hip pain continues to interfere with your day to day activities, surgery may be recommended.
Hip Impingement Surgery And Recovery?
Surgical treatment of hip impingement involves reshaping the femur and acetabulum, as well as repairing any labral tears and areas of impingement around the hip. This is done arthroscopically through two small (1cm) incisions around the hip through the use of a series of burrs and shavers. Surgery typically takes 2-3 hours, and most patients go home the same day of surgery. Crutches are required for the first month and you can expect returning to sports by 6-9 months, depending on your recovery.
