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Hip Impingement

​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​Hip impingement is a disorder caused by excess bone and, therefore, lack of space between the neck of the femur and the rim of the socket.

This lack of space causes the neck and rim of the socket to rub together, particularly when the hip is flexed, which leads to pain and, potentially, early onset of arthritis. The primary symptom of hip impingement is pain in the hip area during or after the hip has been in a flexed position, such running or jumping or sitting for long periods.

Treatments

If your impingement is causing pain or limiting movement in everyday activities, an orthopedic surgeon may recommend arthroscopic or open surgery.

Arthroscopy - During an arthroscopic procedure, miniature instruments are inserted into small incisions made in the hip. Then the head of the femur and/or the socket are reshaped by removing excess bone.

In more severe cases or if other repairs are necessary, an open surgery may be required to repair the impingement. In this procedure, the head of the femur and/or socket are also reshaped by removing excess bone, but a large incision is made to access the hip.

​More information on hip impingement surgery:​

Hip Arthroscopy: Repairing Femoroacetabular Impingement

Cross section of hip joint showing abnormal bump of excess bone on ball of thighbone. Excess bone is also on lip of socket.

Closeup of arthroscope tip in hip joint and burr removing excess bone.

Cross section of hip joint showing excess bone reshaped from femoral head and lip of socket.

When excess bone has formed on the edge of the “ball” (femoral head) and/or the “socket” (acetabulum) of the hip, it is called femoroacetabular impingement (FAI). FAI can cause pain and limit movement. Requiring only small incisions and special instruments, arthroscopy can repair FAI. 

In the Operating Room

Just before surgery, you may be asked several times which hip is to be treated. This is a standard safety measure. In the operating room, you will likely receive general anesthesia to make you sleep.

During the Procedure

After you receive anesthesia, your leg is gently pulled to distract, or widen, the hip joint. Next, the surgeon makes a few small incisions called portals. Through these portals, he or she inserts surgical tools, including the arthroscope. The arthroscope sends images of the joint to a video screen. These images allow the surgeon to look inside the joint. The joint is filled with sterile fluid to help the surgeon see more clearly.

Repairing Femoroacetabular Impingement

To treat FAI, the area is reshaped by removing excess bone. Excess bone can be removed from the socket side or ball side of the hip joint. FAI can lead to other problems, such as labral tears or chondral damage. If present, these problems are also treated. Once the surgeon finishes the procedure, the portals are closed and bandaged. Then you are taken to the recovery room.

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 Hip Replacement

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