What is hip impingement?

In a smooth-functioning hip, the rounded top of the femoral head (thigh bone) fits perfectly into the hip socket. A thin layer of cartilage lines the ball and socket, cushioning and protecting the bones, and preventing them from rubbing against each other. A ring of soft elastic tissue, called the labrum, provides stability and helps keep the femoral head in place.

Hip impingement occurs when the bones in the hip joint develop abnormally during childhood. Also called femoroacetabular impingement, it causes the hip bones to rub against each other, breaking down the articular cartilage and tearing the labrum. If left untreated, this process can lead to progressive pain, cartilage damage and premature arthritis in young adults. 

There are two types of hip impingement:

• Pincer. Extra bone extends over the normal rim of the acetabulum (the hip socket), which can crush the labrum.
• Cam. Because it is not round, the femoral head cannot rotate smoothly inside the acetabulum.

What is the treatment?

Hip impingement often responds to non-operative treatment, including rest, activity modification, anti-inflammatory medications, corticosteroid injections and physical therapy. If these methods fail, arthroscopic hip surgery is a promising treatment for hip impingement. In this minimally invasive procedure, the surgeon makes several small incisions around the hip joint and inserts a narrow fiber optic scope (called an arthroscope) to view inside the joint. Tiny instruments are used to clean out or repair torn labrum tissue by sewing it back together. The surgeon then re-shapes the bones of the hip joint.

Arthroscopic repair of labral injuries allows surgeons a full view of the hip without having to cut through nerves or muscles. Patients experience less pain and blood loss and fewer complications. The result is a more balanced, stable repair that helps restore full function.

Because hip arthroscopy is a minimally invasive procedure, the typical recovery period is weeks rather than months. Rehabilitation begins immediately after surgery and includes special exercises to restore range of motion, strength and flexibility in the hip. Most patients return to normal activities within a few weeks. For athletes, full return to sports may take four to six months.