Femoroacetabular impingement, also called hip impingement, occurs when extra bone develops along one or both bones that form the hip joint. This irregular shape causes the bones to contact each other during movement. Over time, the resulting friction can damage the cartilage and other structures within the joint, causing pain and contributing to labral tears or osteoarthritis.
Dr. Brian Cohen is a board-certified orthopedic surgeon with more than 20 years of experience, over 30,000 orthopedic surgical procedures performed, and more than 100,000 patient evaluations. He evaluates the shape of the hip joint, the location of the damage, and the patient’s symptoms to develop an individualized treatment plan. The type of impingement present is an important part of that evaluation.
Types Of Hip Impingement
There are three main types of femoroacetabular impingement:
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Pincer impingement: Extra bone develops along the rim of the acetabulum, which is the socket of the hip joint. This may limit normal movement or pinch the labrum, the ring of cartilage surrounding the socket.
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Cam impingement: A bony prominence develops along the femoral head or neck. This irregular shape may rub against the cartilage and labrum during hip movement.
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Combined impingement: Features of both pincer and cam impingement are present.
Diagnosing Femoroacetabular Impingement
Diagnosis begins with a review of the patient’s symptoms, activity level, medical history, and the movements that increase pain. A physical examination is then used to evaluate hip motion, muscle strength, tenderness, and walking mechanics.
The examination may include an impingement test. During this maneuver, the knee is brought toward the chest and rotated inward toward the opposite shoulder. Pain from this movement may indicate irritation in the hip joint.
Imaging may include:
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X-rays to evaluate the shape and alignment of the hip bones
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MRI to identify labral tears, cartilage damage, or other soft-tissue injuries
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CT imaging when a more detailed assessment of the bone structure is needed
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Ultrasound to evaluate surrounding soft tissues or guide an injection
An image-guided injection around or within the hip joint may also help determine whether the pain is coming from inside the joint.
Hip Impingement Causes And Risk Factors
Femoroacetabular impingement develops when the bones of the hip joint do not form with a typical shape during childhood and adolescence. The abnormality may involve the rim of the socket, the femoral head and neck, or both areas.
Some impingement patterns are diagnosed more frequently in certain age groups or sexes, but the condition can affect a wide range of patients. Athletes and physically active individuals may notice symptoms earlier because repeated bending, pivoting, or deep hip flexion places greater stress on the joint.
Physical activity does not cause abnormal bone growth. However, repetitive movements may aggravate the labrum and cartilage when impingement is already present.
Hip Impingement Symptoms
Symptoms of femoroacetabular impingement may develop gradually and often worsen with repeated hip movement.
Common symptoms include:
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Hip or groin pain
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Decreased range of motion
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Pain after sitting for long periods
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Pain with bending, twisting, or squatting
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Limping
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Locking, clicking, or catching within the joint
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Stiffness
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Pain that may extend into the thigh, buttock, or lower back
Symptoms may become more noticeable during sports, exercise, or activities that require deep hip flexion.
Hip Impingement Treatment Options
Treatment for femoroacetabular impingement depends on the shape of the hip joint, the severity of the symptoms, the presence of labral or cartilage damage, and the patient’s age, activity level, and overall health.
Nonsurgical care is often recommended first. Surgery may be considered when pain and limited motion continue despite appropriate treatment or when significant joint damage is present.
Nonsurgical Treatment
Initial treatment often focuses on reducing pain, improving hip movement, and limiting activities that place pressure on the irritated joint.
Nonsurgical care may include:
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Activity modification
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Temporary rest from painful sports or exercises
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Physical therapy
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Strengthening and flexibility exercises
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Nonsteroidal anti-inflammatory medication
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A corticosteroid injection when appropriate
These treatments may improve symptoms and help patients move more comfortably. However, they do not change the underlying shape of the hip bones.
Surgical Treatment
Surgery may be recommended when hip pain and limited motion continue despite nonsurgical treatment. The goal is to improve joint clearance, reduce abnormal contact, and treat related damage when possible.
Depending on the patient’s anatomy and joint condition, surgery may involve:
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Reshaping excess bone along the femoral head, neck, or acetabulum
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Repairing or trimming a damaged labrum
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Treating areas of injured cartilage
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Addressing other abnormalities within the hip joint
Dr. Cohen reviews imaging, symptoms, activity goals, and the degree of arthritis before recommending a surgical approach.
Why Choose Dr. Cohen?
OVER 25+ YEARS OF EXPERIENCE
One of the first orthopedic surgeons employed by a large hospital. Dr. Cohen spent 20 years.
TRUSTED BY OVER 100,000+ PATIENTS WORLDWIDE
Over his distinguished career, Dr. Cohen has cultivated a reputation of excellence and trust among his patients and his peers.
UTILIZING THE LATEST TECHNOLOGY
To achieve the best surgical outcomes, Dr. Cohen uses the most advanced technologies and techniques, keeping his practice state-of-the-art.
PATIENT SAFETY IS TOP PRIORITY
An individualized, patient-focused process coupled with decades of training and experience helps ensure maximum safety for all of Dr. Cohen’s patients.
Hip Impingement Care in Chillicothe, OH
Femoroacetabular impingement can cause persistent pain, stiffness, and damage within the hip joint. Treatment may include activity modification, physical therapy, medication, injections, or surgery based on the patient’s anatomy and symptoms. Dr. Cohen develops a personalized plan designed to improve movement and protect long-term joint function. To schedule a consultation with Dr. Brian Cohen, call (614) 788-0375.
