Educational information for Hip Injuries including Femoroacetabular Impingement (FAI) and Hip Labral tear.
Femoroacetabular Impingement (FAI) and Hip Labral tear
The hip joint is a “ball and socket” joint. The femoral head is the “ball” while the acetabulum is the “socket.” FAI occurs when extra or abnormally shaped bone around the hip joint causes pinching of the labrum and cartilage.
How do injuries occur?
FAI and hip labral tears often occur due to 2 different issues. Extra or abnormally shaped bone at the femoral neck (CAM lesion) can contact the rim of the acetabulum during certain motions, particularly when the hip is flexed, adducted (brought towards the middle), and internally rotated. This contact can damage the labrum and cartilage of the hip joint. There can also be extra bone at the acetabulum (pincer lesion), which can cause the labrum to pinch and tear as well. Many patients have a combination of both a CAM and a pincer lesion. Patients involved in sports and activities that require repetitive hip flexion can cause the labrum and cartilage to eventually break down and tear.
Signs and Symptoms
Patients with FAI and a hip labral tear will often have deep aching in hip and groin. The pain is worse after periods of sports and activities that require repetitive hip flexion. Certain motions or hip positions can cause sudden sharp pain of the hip and groin. Remaining in a seated position, such as while driving or in school, can be difficult and uncomfortable. Some patients will feel clicking or snapping in hip joint as well. This can indicate that other issues may be present, such as hip flexor irritation and tendinitis.
For patients with FAI and hip labral tears, non-surgical treatment is the initial treatment step. Treatment is focused on reducing pain, restoring motion, and regaining strength with a specific physical therapy program. Once the pain is improved with rest, a rehabilitation program focused on strengthening the core, hip, and thigh muscles is implemented to recondition the hip. Once the hip has improved in strength and flexibility, sport-specific training is performed to prepare the patient for return to sports and activities.
For many patients, non-surgical treatment can provide the relief necessary to return to sports and activities. However, some patients may not improve as expected and surgery may be recommended in these cases. There are many surgical options based upon the presence of CAM lesions, pincer lesions, labral tears, and cartilage tears. Dr. Kumar will discuss surgical options with you prior to surgery. Age, sports, physical exam, and radiology findings all play a role in determining which procedure may best work for each patient. After surgery, a rehabilitation program specific for each patient is created with a physical therapy team in order to reduce post-surgical pain, restore motion, and regain strength. Sport-specific training is a critical aspect of recovery in order to return patients to sports and activities as quickly and safely as possible.