Femoroacetabular Impingement: Symptoms, Causes, and Treatment
Hip pain can quickly disrupt your daily routine, making simple movements feel impossible. If you experience a sharp catch in your groin when tying your shoes or deep aching after a long drive, you might be dealing with a structural hip issue. This guide explains everything you need to know about femoroacetabular impingement. We cover how the condition develops, how everyday movements aggravate it, and the most effective ways to treat it.
What is Femoroacetabular Impingement?
To understand what is femoroacetabular impingement, it helps to first look at the hip joint. Your hip is a ball-and-socket joint. The “ball” is the femoral head (the top of your thigh bone), and the “socket” is the acetabulum (part of your pelvis). A healthy hip joint features smooth cartilage that allows the ball to glide effortlessly within the socket.
Femoroacetabular impingement occurs when extra bone grows along one or both of these bones. This overgrowth gives the bones an irregular shape, preventing them from fitting together perfectly. Because they do not fit correctly, the bones rub against each other during movement. Over time, this friction damages the cartilage and the labrum (a ring of cartilage that seals the joint).
Medical professionals often refer to this condition as femoroacetabular impingement FAI. If left untreated, this constant joint friction can lead to early osteoarthritis.
Types of Femoroacetabular Impingement
Orthopedic specialists classify hip impingement into three main categories based on where the extra bone growth occurs.
- —Pincer Impingement: This type occurs when extra bone extends out over the normal rim of the acetabulum (the socket). The prominent socket rim pinches the labrum when you bend your hip.
- —Cam Type Femoroacetabular Impingement: In this variation, the femoral head (the ball) is not perfectly round. Because it lacks a smooth spherical shape, the ball cannot rotate freely inside the socket. Instead, a bump forms on the edge of the femoral head, grinding the cartilage inside the socket.
- —Combined Impingement: Most people with this condition actually have a combination of both pincer and cam impingement.
Femoroacetabular Impingement Symptoms
Many people have irregular hip bones but never experience pain. However, once the joint sustains enough damage from friction, femoroacetabular impingement symptoms will begin to disrupt your life.
You might notice these common signs:
- —A deep ache in the groin area, especially after sitting for long periods.
- —Sharp, stabbing pain when you turn, twist, or pivot.
- —A catching or clicking sensation in the front of your hip.
- —Stiffness and reduced range of motion.
These symptoms often appear during specific everyday activities. You might feel a sharp pinch when getting in and out of a car, or experience deep aching while squatting to pick up a box. Athletes often notice a drop in performance, particularly in sports that require deep hip flexion, like hockey, soccer, or martial arts.
Causes and Risk Factors
Hip impingement happens because the hip bones do not form normally during the childhood growing years. It is the deformity of a cam bone spur, pincer bone spur, or both, that leads to joint damage and pain.
While you cannot control how your bones develop, certain risk factors make you more likely to experience symptoms:
- —Athletic activity: High-impact sports heavily stress the hip joint, making athletes more likely to notice pain from the abnormal bone shape.
- —Genetics: You may inherit the tendency to develop abnormal bone shapes in your hips.
- —Childhood hip diseases: Conditions like Legg-Calve-Perthes disease or slipped capital femoral epiphysis can alter bone development.
Diagnosis
You should seek a proper medical evaluation if your hip pain lasts more than a few days. An orthopedic specialist handles the diagnosis and treatment of structural hip issues.
During your visit, the doctor will review your medical history and conduct a physical examination. They will likely perform the impingement test by bringing your knee up toward your chest and rotating it inward. If this motion recreates your specific groin pain, it strongly indicates hip impingement.
To confirm the diagnosis, your doctor will order imaging tests:
- —X-rays: These provide clear images of your bone structure to identify cam or pincer bone spurs.
- —MRI scans: These scans show soft tissue damage, allowing the doctor to see tears in the labrum or damage to the articular cartilage.
For medical billing and documentation, your provider will assign a specific femoroacetabular impingement ICD 10 code based on whether the condition affects your right, left, or both hips.
Femoroacetabular Impingement Treatment Options
Treating hip impingement focuses on managing pain and improving mobility. A standard femoroacetabular impingement treatment plan usually begins with non-surgical methods.
Here are the most common non-surgical femoroacetabular impingement treatments:
- —Activity modification: Avoid the specific movements that cause pain. This might mean adjusting your squat depth or taking a break from high-impact sports.
- —Nonsteroidal anti-inflammatory drugs (NSAIDs): Over-the-counter medications like ibuprofen can reduce pain and inflammation.
- —Physical therapy: A physical therapist can teach you specific exercises to improve the range of motion in your hip and strengthen the muscles supporting the joint.
- —Corticosteroid injections: If rest and physical therapy do not provide relief, your doctor might inject a strong anti-inflammatory medication directly into the hip joint to temporarily reduce pain.
Femoroacetabular Impingement Surgery
If non-surgical treatments fail to relieve your pain, your orthopedic specialist may recommend femoroacetabular impingement surgery. Surgery aims to correct the structural abnormality and repair any damaged soft tissue.
Today, surgeons typically perform this procedure arthroscopically. Hip arthroscopy is a minimally invasive surgery where the doctor makes small incisions and uses a tiny camera to view the inside of the joint. Using specialized miniature instruments, the surgeon can:
- —Trim away the bony rim of the socket (pincer).
- —Shave down the bump on the femoral head (cam).
- —Repair or clean up a torn labrum.
- —Smooth out damaged articular cartilage.
Arthroscopic surgery generally results in less pain and a faster recovery compared to traditional open hip surgery.
Recovery and Prognosis
Recovery from hip arthroscopy takes time and patience. You will likely need crutches for the first few weeks to protect the repaired joint. Physical therapy begins almost immediately to restore your hip’s strength and flexibility.
Most patients return to light, everyday activities within a few weeks, but full recovery and a return to high-impact sports can take three to six months. By successfully reshaping the joint, surgery relieves pain and frequently prevents future damage to the hip joint.
Schedule an Evaluation
Hip impingement can severely limit your mobility and enjoyment of daily activities. Recognizing the early signs and seeking a professional medical evaluation can help prevent long-term joint damage. Whether you manage your condition with physical therapy or require arthroscopic surgery, modern treatments offer excellent outcomes for restoring your active lifestyle. If you frequently experience groin pain during routine movements, schedule an evaluation with an orthopedic specialist to discuss your hip health and map out a treatment plan.
