The hip is a ball and socket joint that is formed by the head of the femur (thigh bone) fitting securely into the acetabulum (socket) which is part of the large pelvis bone. The joint surface is covered with a slippery tissue called articular cartilage. This helps the ball and socket move smoothly together, without friction during movement. The acetabulum has a rim of strong fibrocartilage that helps hold the femur securely within the socket, forming a gasket and creating a tight seal which offers hip stability. If you have been diagnosed with a hip condition, like a hip labrum tear and are looking for a second opinion, our doctors at BICMD are experts in orthopedic hip conditions and can provide you with an on-demand virtual consultation.
What is FAI?
FAI is the acronym for Femoroacetabular Impingement, it occurs in the hip when additional bone grown occurs on one or both of the bones that form the ball and socket joint. The additional bone growth, sometimes called bone spurs, cause an abnormal or irregular shape which allows the bones to rub against each other during movement. When the extra bone forms on the femoral head/neck this is referred to as a CAM deformity. The result of this extra bone growth is the pinching, or impingement of the joint. Over time, this will cause the articular cartilage to become worn and damaged, resulting in pain, catching within the joint, and limited range of motion. This condition may begin early in childhood and is a major contributing cause of early degenerative joint disease of the hip in young, active patients.
What is a Hip Labrum Tear?
The hip labrum is made up of strong, flexible fibrocartilage that sits on the acetabulum (socket) of the hip joint. The job of the hip labrum is to hold the ball of the femur (thigh bone) securely within the acetabulum. It acts as a gasket, creating a tight seal that offers hip stability while the joint moves through its full range of motion.
A hip labrum tear occurs when this strong fibrocartilage tears away from the acetabulum, either partially or completely. Femoral acetabular impingement can be one of the causes of a torn hip labrum when the misshaped bone damages the hip labrum. This condition may begin in childhood and is a major contributing cause of early degenerative joint disease of the hip in young, active patients.
Are there different types of hip impingement or FAI?
Femoroacetabular impingement is classified by two distinct types. Patients may have one or the other type, or they may have a combination. These types of impingement are:
Cam Impingement: A Cam hip impingement occurs when the femoral head is misshaped. If the head of the femur is not smooth or round, it cannot move or rotate correctly inside the acetabulum (socket). The result of a misshapen femoral head can cause excessive grinding and wear against the cartilage inside the joint, which can tear the labrum.
Pincer Impingement: This type of hip impingement can be caused when the socket of the hip is too deep. Pincer Impingement can also occur when extra bone on the acetabulum (socket) extends further than it should, over the edge of the femoral head. This can cause the labrum to pinch, or crush and the articular cartilage can be damaged.
Combined Impingement: Combined hip impingement is when both a misshaped femoral head and extra bone on the acetabulum, causes the uneven wear and tear of the cartilage. Both Pincer and Cam impingement will cause pain and excessive wear within the joint capsule.
What are the symptoms of femoroacetabular impingement?
Typical symptoms experienced in patients with FAI are:
Hip pain; can be stabbing or a dull ache
Stiffness in the hip with decreased range of motion
Deep groin pain with certain activities
A locking sensation in the hip
A catching sensation in the hip or groin
Pain after sitting for a long period of time
Pinching, felt in the hip when flexing the joint beyond 90 degrees
Hip pain with exercise or sports
Hip pain that radiates to the thigh, buttock or knee
A limp when standing to walk
How is FAI or Hip Labrum Tear diagnosed?
The specialists at BICMD have extensive training and experience in diagnosing FAI, Hip Labrum Tear, Cam Impingement, Pincer Impingement or a combination. Typically, femoroacetabular impingement can be seen on x-ray and in an MRI. As part of your consultation, BICMD experts can review your x-ray or MRI to evaluate the bone and soft tissue. Through our telemedicine platform you can consult with your selected expert to discuss your diagnosis and treatment options – without the need for special travel. A correct diagnosis and appropriate treatment plan or second opinion by our orthopedic experts who are “best in class,” can make the difference between a fair recovery and a great recovery.
What is the treatment for femoroacetabular impingement?
If you’ve tried non-surgical treatments and they have failed to alleviate pain, surgical intervention may be needed. Our physicians will only recommend surgery for FAI when conservative treatment has not helped, or if the condition has worsened. FAI impingement can typically be treated arthroscopically, using small incisions and a small camera called an arthroscope. Small, specialized instruments help the doctors to operate inside the hip joint, offering less bleeding, less chance of infection and a quicker recovery time.
Would you like more information on FAI, Femoroacetabular Hip Impingement or labrum tears? Are you experiencing hip pain or have you been diagnosed with hip impingement, FAI or a torn labrum? Please click on Connect With a Doctor” to reach one of our orthopedic telemedicine experts and to use our state-of-the-art telehealth platform.