FAI of the Hips

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Femoroacetabular impingement (FAI) is an abnormality in the hip. Another name for FAI is hip impingement. The hip is a ball and socket joint. It is the point where the thigh bone meets the pelvis bone. Normally the hip joint fits into place, and it gives you a wide range of motion. In FAI, the pelvis bone and the femur bone do not fit together properly, and it causes the bones to rub together. With the hip bones not fitting together properly, the other structures of the hip are not in place. This condition eventually leads to a lot of pain.

The hip joints are made in a way that allows you to move without much limitation. It is because of the hip joint that you can jump, bend down, and run. If you are a gymnast, you appreciate a properly working hip joint. It helps you with splits and flips. The ball and socket joint is held together by ligaments and tendons. It keeps the ball from coming out of its socket. The hip joint also contains cartilage called the labrum. The labrum keeps the bones from rubbing together. If the bones of the hips rub together, the bones will eventually wear down. In the long run, it may cause osteoarthritis. Take notice of your symptoms so that you can get the help you need.

Symptoms

The funny thing about FAI is that you do not have any symptoms initially. You will think everything is normal. When pain begins to come, you may only feel pain when you overuse the thigh. Stretching the leg too much can also cause a lot of pain. As time progresses, you begin to feel stiff. Your range of motion is limited in the thigh joint. Moving the thigh too much leads to pain. Pain will soon start to happen after you sit too long. Walking uphill will also be difficult. When pain occurs while you are resting, it could mean the cartilage is wearing away. Cartilage degradation is a serious problem that leads to osteoarthritis.

Types of FAI

There are three types of FAI: combined impingement, cam, and pincer.  Pincer FAI is a result of a bone spur. The pelvic bone grows to the point that it extends over the femur bone. The extra piece of bone extends over the rim and can crush the cartilage between the femur and pelvic bone. Cam impingement results in the head of the femur bone not being completely round, which effects hip rotation. The femur bone will also make a bone spur. It looks like a bump on the bone. The bump will also wear away the cartilage between the bone. Combined impingement is a result of both cam and pincer impingement. These problems may develop as you age or start from birth

Causes

FAI is something you typically develop over the years. Bone spurs are one cause. Bone spurs can happen out of nowhere. It is just an outgrowth of bone normally found around the joint. As a child, it takes time for your hip joints to develop. If you notice, baby’s legs are very flexible. They almost sit in a split. The ligaments and tendons have done developed fully. As the child gets older, their hip joint moves into the right place. You still have a wide range of motion but not like you did as a baby. If there is a malfunction in the development of the joint, you will eventually form FAI. It will take years before you feel any symptoms. If you are an athlete, you will bring symptoms much quicker.

Diagnosis and Treatment

Impingement is diagnosed during an office visit with either an orthopedic doctor or sports medicine doctor. The doctor will examine your range of motion by moving your hip joint around. If you are experiencing a lot of pain, it is more times than not FAI. The next step is to have imaging done. The imaging shows what impingement you have as well as cartilage breakdown. The imaging tests include X-ray, CT scans, and MRI scans. If your cartilage still looks good, then the doctor may suggest medication and physical therapy.  You may have to stop certain physical activities. This can be difficult because you do not want to stop exercising altogether. Physical therapy will help gain your range of motion back and lessen the pain. If your pain gets worse or the cartilage wears down, you will have to have surgery. Most surgeries for FAI include cleaning the cartilage damage and cutting down the bone that is causing the pain. This surgery can be done arthroscopically by using an arthroscope. In more severe cases, the whole hip will be exposed through a large incision.

Femoroacetabular Impingement (FAI) is a condition we can go our whole lives with and not know. The onset of the condition is not serious and typically does not affect walking. When you begin to feel symptoms, it is time to seek medical attention. By catching FAI early, you can avoid surgery. When you let the symptoms continue, you will eventually have to have surgery to repair the cartilage in your hip. Don’t let FAI keep you down. Get treated and get back to your active life.

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