Young and Active? – Don’t Ignore Hip Pain

March 15, 2016 Brigham and Women's Hospital

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Femoroacetabular impingement (FAI) is a condition where the bones forming the ball and socket of the hip joint are abnormally shaped and do not fit together properly. Types of FAI include cam impingement, pincer impingement, and combined impingement (cam and pincer).

Many young and active adults who experience hip pain during exercise attribute the discomfort to overdoing it during a workout. That may be a mistake, says Dr. Scott Martin, an orthopedic specialist at Brigham and Women’s Hospital.

“If you are in your 20s, 30s, or 40s, and you have repeat hip pain, stiffness, or a catching sensation in the hip during movement, you should be evaluated for a condition called femoroacetabular impingement,” says Dr. Martin. “Left untreated, this condition can lead to extensive damage of the hip joint over time, ultimately resulting in the need for a hip replacement.”

Femoroacetabular impingement, commonly known as FAI, is a condition where the bones forming the ball (femoral head) and socket (acetabulum) of the hip joint are abnormally shaped and do not fit together properly. The rubbing of the bones can create bone spurs that damage hip cartilage designed to enable smooth and stable movement of the hip joint.

Evaluation for FAI is typically performed during an office visit to an orthopedic specialist, who manually rotates the hip and assesses movement and discomfort. Imaging, such as x-ray and MRI, can show evidence of bone spurs, bone erosion, and misshapen hip structures in FAI. Treatment for FAI can range from conservative management, including rest and avoidance of certain activities, to surgery, which may be required to fix and prevent further damage.

Among the newest surgical treatments for FAI are arthroscopic (minimally invasive) techniques to repair existing damage and prevent or delay the need for a hip replacement. Dr. Martin pioneered an innovative arthroscopic technique that enables more complete healing and has been associated with good outcomes, including relieving symptoms in the majority of patients. A review of cases found that 95 percent of patients who underwent this technique did not need hip replacement seven and a half years after the procedure.

“The most important thing is to catch FAI early,” says Dr. Martin. “Beyond a certain point, the only treatment available will be total hip replacement.”

– Jessica F.

 

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