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HIP | CONDITIONS AND MANAGEMENT
FEMOROACETABULAR IMPINGEMENT
What is femoroacetabular impingement?
A disorder known as femoroacetabular impingement (FAI) develops when the bones of the hip joint don’t fit together correctly. The femoral head pressing against the acetabulum causes FAI to occur. This may harm the joint, resulting in discomfort, stiffness, and reduced range of motion. There are three main types of FAI:
- Cam impingement – A femoral head malformation brings the first type of FAI. The ball appears to be more oval than circular in this particular form of impingement. When the ball strikes the edge of the cup, this shape causes friction.
- Pincer impingement– When the acetabulum has an unusual form, impingement of the second kind of FAI When the edge of the cup makes contact with the head or neck of the femur, it can cause friction since the cup’s head is overly covered.
- Combined impingement occurs when both pincer and cam types are present.
What causes Femoroacetabular impingement?
Deformities in the femur, the hip socket, or both can lead to FAI. The ailment may manifest at birth or develop as the child grows. This can lead to either a shallow hip socket or a big femur head, which will cause the bones to scrape against one another when moving. In some cases, FAI can also be caused by repetitive stress, wear and tear of the joint, bony overgrowth, trauma, decreased range of motion and obesity.
What are the signs of Femoroacetabular impingement?
FAI symptoms can include hip discomfort that gets worse with exercise or extended sitting, as well as soreness or hurting in the inner hip or groin area, generally after walking or prolonged sitting. Other FAI symptoms and indicators include discomfort and groin stiffness at the front of the thigh, which frequently worsens when the hip or waist is bent upward. Limited range of motion and decreased athletic performance are also common symptoms of FAI.
How does Dr van Niekerk check for femoroacetabular impingement?
Normally, Dr van Niekerk conducts an x-ray or MRI to check for signs of damage to the hip joint. He may also decide to perform a physical test to rule out or confirm impingement.
How do you treat femoroacetabular impingement?
Initially, Dr van Niekerk advises conservative measures, including rest, activity modification, nonsteroidal anti-inflammatory medications, cortisone injections, and physical therapy. However, you might be a candidate for surgery if your pain does not go away with these treatments.
Is there surgery for femoroacetabular impingement?
Surgery may be required in difficult situations to address the root cause of FAI and treat symptoms. There are two main objectives of surgical therapy for FAI. Taking care of the hip joint’s injured area comes first. The second is to improve or repair the hip joint’s abnormal shape. Surgical options can include:
- Cam resection – To reduce impingement, a tiny part of the femoral head may be removed.
- Hip arthroscopy – Damaged tissues are removed, and the bones are reshaped using a small camera and tools.
- Labral repair – Hip arthroscopy can be used to repair or reattach the labrum if it has been torn.
- Pincer resection – A tiny piece of the acetabulum may be removed to reduce impingement.
- Total hip replacement – An artificial joint is put in the hip’s place after the injured one is removed.
What is recovery like?
Generally, patients can anticipate a one- to three-day hospital stay following Femoroacetabular impingement (FAI) surgery, though this might vary depending on the technique and the patient. Dr van Niekerk will keep an eye on the patient’s development and give directions for recovery and postoperative care. Depending on the treatment, FAI surgery recovery times can also vary. Painkillers provided by Dr van Niekerk and physical therapy are typically part of the rehabilitation process. Rest is imperative to recovery, and so is gradually returning to activities. In most cases, patients can anticipate returning to their regular activities in a few months, but Dr van Niekerk and the patient’s physical therapist will decide when this is appropriate. Follow-up visits with Dr van Niekerk and the physical therapist regularly can assist in tracking development and guarantee a quick and complete recovery.
FAQ
Dr van Niekerk typically needs one to three hours to complete a procedure. However, based on a thorough assessment of your unique needs, Dr van Niekerk will be able to give a more precise estimate of the time required for your particular FAI surgery.
Compared to open surgery, minimally invasive arthroscopic methods produce less discomfort and a speedier recovery. In addition to prescribed medicines, physical therapy may also be used, depending on the situation.
In the days or weeks after surgery, patients will typically have one or more follow-up sessions to check on their recovery, examine the incision site, and receive instructions for postoperative care and recovery. Patients may schedule further follow-up consultations with Dr van Niekerk and their physical therapist throughout the rehabilitation process to assess their progress and modify their treatment plan. The precise number of follow-up visits will depend on the patient in question, and the treatment carried out. Dr van Niekerk can provide a more precise estimate based on your requirements.