The hip is a ball-in-socket joint that is designed to be stable and move smoothly within a limited range. The socket (acetabulum), which is part of the pelvic bone, generally matches the contour of the ball (head of the femur or thigh bone) very closely, allowing for smooth motion between the two. Sometimes a mismatch between the ball and the socket can exist, when, for example, an ovoid ball sits in a hemispherical socket. In some people the femoral head can have a “bump” also known as a cam lesion, or the acetabulum can have excessive overhang like an awning, also known as a pincer lesion. All these anatomic variants can lead to what is known as femoro-acetabular impingement (FAI), which represents symptomatic aberrant contact between parts of the hip joint, when the hip is brought in specific positions within the normal range of motion.

Patients usually complain of pain in the hip or groin area, associated with specific hip motions and positions like squatting or sitting in low seat. Motion in specific directions can be limited and painful. Sometimes a painful catching sensation may be felt if associated labrum damage is present.
The diagnosis is typically made by a combination of the patient’s history, the findings on physical examination and special x-ray evaluation to define the anatomy, as well as a contrast-enhanced MRI scan or arthrogram to evaluate the labrum. Sometimes a CT scan is necessary if surgery is being considered.
The treatment approach depends on the symptoms experienced by the patient, the age and activity level of the patient, the pattern of the lesions, and the presence of arthritis, among other factors. Conservative options include rest, activity modification, anti-inflammatory medication and steroid injections which have a diagnostic and therapeutic value. For patients with persistent pain and/or functional limitations, minimally invasive arthroscopic surgery of the hip can be considered. Surgery involves carefully trimming down impinging bony lesions on the femoral head (femoroplasty) and/or acetabulum (acetabuloplasty). Often, additional associated arthroscopic procedures, like labral debridement or repair is needed to address associated lesions and ensure surgical success.

At Oceana Sports Medicine and Orthopaedic Center, Dr. Aboka will thoroughly evaluate your hip condition and discuss your options. If surgery is indicated, Dr. Aboka specializes in minimally invasive, Hip Arthroscopy for the treatment of Femoro-Acetabular Impingement. This procedure is outpatient/same-day surgery, and leads to improvement or resolution of pain, and minimal scarring and quicker recovery.