Hip Femoroacetabular Impingement (FAI) and Labral Tear

Femoroacetabular impingement (FAI) is a common condition in the adolescent to middle age adult populations. FAI refers to repetitive abnormal contact that occurs between certain aspects of the ball (femoral head) and socket (acetabulum) portions of the hip joint. When this abnormal contact happens consistently, a tear of the hip labrum can occur.

FAI can result from a normally shaped hip that is placed in extreme positions, an abnormally shaped hip that may or may not be placed in extreme positions or purely from years of high level repetitive impact sports during early adolescence. Regardless of how it starts, this impingement can cause a reactive bone growth to occur on the femoral head. This is called a “CAM” lesion.  This CAM lesion results from the body’s attempt to strengthen the area of the femoral head that is seeing too much impaction. However, as the CAM lesion gets bigger, it ironically makes the impingement worse. Successful treatment of FAI centers on identifying any abnormal bone and removing it.

The hip labrum is a specialized cartilage that rims the acetabulum, or socket portion of the hip. It serves an essential function in hip stability by providing a suction seal for the hip. In longstanding FAI, the labrum takes a continuous beating and can tear. If not repaired, the labral damage can spread to the adjacent weight-bearing cartilage and lead to cartilage damage and arthritis.

Several cases of impingement can be treated with physical therapy that can focus on re-orienting the hip joint during activities to stop the impingement from occurring and stop or minimize further labral damage. However, if therapy is unsuccessful or if symptoms are too severe, surgical intervention may be warranted.

Fortunately, surgical intervention for FAI and associated labral tears of the hip is almost always arthroscopic. Typically through 3 small incisions, Dr. Pace can remove any abnormal or excessive bone and repair the torn labrum. Sometimes the labral damage is so severe that the labrum will need to be augmented or reconstructed with a tendon graft. This tendon graft can be taken from the patient or from a donor. Surgery is outpatient and most patients are able to resume impact activities such as running at 3 months after surgery.

To find out more about hip arthroscopy surgery, please contact us at (860) 837-9220.

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