Femoro-acetabular Impingement (FAI) is a common cause of pain in the hip. It occurs when there is abnormal contact between the bones of the hip. Impingement can lead to labral tears and eventually advancement of osteoarthritis. Impingement is most commonly described as anatomic boney variability of the acetabulum (socket) and femur (leg bone) that causes the two bones to rub against each other during certain hip motions. It commonly affects those who are involved in repetitive sports, and who are young to middle-aged adults. Dr. Austin Chen, hip specialist serving greater Boulder, Colorado, is available to both diagnose and treat femoro-acetabular impingements of the hip.
There are two distinct forms of hip impingement; Pincer impingement and a non-spherical femoral head, known as Cam impingement. In Pincer impingement, extra bone extends out over the normal rim of the acetabulum, causing the labrum to be trapped between the femoral head and neck. Over time with use of the hip, the labrum will tear and the underlying articular cartilage will be damaged. Often in these cases, Dr. Chen will suggest a acetabuloplasty to surgically repair the boney conflict.
In a cam impingement, the ball-shaped end of the femur (femoral head) is not perfectly round. This interferes with the femoral head’s ability to move smoothly within the hip socket. Some hips have both Pincer and Cam impingement, known as Combined impingement. During hip motion, either during sports or with daily activities, the non-spherical femoral head and socket can continually meet and rub against each other, causing pinching or entrapment of the labrum, commonly leading to a labral tear or joint wear-and-tear.
What is a acetabuloplasty?
If a pincer impingement is present, Dr. Chen will perform an arthroscopic surgery called an acetabuloplasty. Arthroscopic treatment involves trimming the overhang of the acetabular rim, known as an acetabuloplasty and shaving down the bump on the femoral neck, known as a femoroplasty. A femoroplasty involves re-shaping of the femoral head to restore its spherical contour. Both procedures help restore the ability of the ball-and-socket joint to move in all directions without the friction of impingement.
What is the recovery from an acetabuloplasty surgery?
An acetabuloplasty is typically an outpatient surgery that is associated with fairly minimal pain. The average postoperative course involves 2 weeks in a hip brace and 2 weeks on crutches to protect the work done on the hip. A brace may be required for 6 weeks, and crutches may be required for up to 8 weeks if the hip’s condition requires a more extensive surgery. Most patients begin riding a stationary bicycle and begin physical therapy the day after surgery. Physical therapy can be completed through the Boulder Centre for Orthopedics Physical Therapy Center, which offers all patients complete and seamless recovery care. Patients can return to work as soon as 2-3 days after their procedure, depending on their work type. Athletes can expect to return to sports between 3-6 months after surgery. High-level athletes participate in an intense physical therapy course after surgery, gradually increasing their workout intensity.
