Hip Femoroacetabular Impingement (FAI) and Labral Tear

Symptoms:

  • Hip/groin pain. Pain is usually increased with athletics or physical activity. Pain also worsens with deep hip flexion or sitting in a low chair.
  • Most patients have limited range of motion of the hip, especially flexion and internal rotation.
  • The labrum is a ring of cartilage in the acetabulum (socket). Labral tears are commonly found in the setting of FAI.

Diagnosis:

  • X-rays: Demonstrate abnormal shape of the bones. There are 2 types of FAI. Cam impingement refers to an extra amount of bone on the femur. Pincer impingement refers to too much bone on the socket (acetabular) of the hip.
  • MRI arthrogram and/or CT scan can be used to further evaluate the hip. MRI may demonstrate a labral tear. CT scans demonstrate the shape of the hip in more detail. Three dimensional images can be obtained with CT imaging. This allows for precise diagnosis of where the abnormal bone.

Treatment:

  • Non-operative treatment includes physical therapy exercises, avoidance of aggravating activity, and possible corticosteroid injection.
  • Surgical treatment includes hip arthroscopy with osteoplasty (reshaping the bones) and possible labral repair. It is important to treat both the bony impingement as well as the labrum as labral tears often recur if the bony structure is not corrected at the time of surgery.

Post-operative Care:

  • Arthroscopic surgery for FAI is outpatient (patients go home the day of surgery)
  • Crutches and a brace are used for 2-6 weeks post-operatively (dependent on exact procedure).
  • A continuous passive motion machine (CPM) is used for the first few weeks after surgery to begin passive range of motion.
  • Physical therapy is used necessary for a few months after surgery to restore range of motion, strength, and proprioception.
  • Full return to sports 4-6 months post-operatively.

 

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