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Femoroacetabular impingement and labral tears

Femoroacetabular impingement and labral tears

Description

Femoroacetabular impingement (FAI) is a condition where the “ball” (femoral head) and the “socket” (acetabulum) do not match. This leads to damaging friction around the hip joint that can cause damage to the labrum or cartilage. A labral tear occurs when the labrum, an elastic tissue surrounding the ball and socket hip joint, becomes injured with activity or due to FAI.

Symptoms

Patients can present with pain with certain activities, stiffness and limping.

Evaluation

  • X-rays provide good images that will show whether the hip has abnormally shaped bones. They can also show signs of arthritis.
  • Computed tomography (CT) scans are more detailed than a plain X-ray. They help the physician see the precise abnormal shape of the hip.
  • Magnetic resonance imaging (MRI) scans produce better images of soft tissue. They help physicians find damage to the labrum and articular cartilage.
  • A local anesthetic, or numbing medicine, may be injected into the hip joint. If the anesthetic provides temporary pain relief, it can help confirm the diagnosis.

Surgical treatment

If the evaluation confirms a diagnosis of FAI, joint damage is present, and nonsurgical treatments prove to be unsuccessful, the physician may recommend surgery.

Arthroscopy

At Shriners Hospitals for Children — Greenville, arthroscopic surgery is one of the treatment options for some types of FAI problems. This type of procedure utilizes small incisions and instruments. The surgeon uses an arthroscope, or a small camera, to view inside the hip.

During the surgery, the surgeon will repair or clean up any damage to the labrum and articular cartilage. Surgery may also involve trimming the bony rim of the acetabulum and/or shaving down the bump on the femoral head.

Open surgery

Some severe cases may require an open operation with a larger incision to accomplish similar goals.