Hip impingement: 4 things to know

bone-joint

Posted: July 6, 2020

[caption id="attachment_15052" align="alignright" width="450"]A woman works in her garden. Hip impingement is caused by excess bone and, therefore, lack of space between the neck of the femur and the rim of the socket.[/caption] Hip impingement, the medical term being femoroacetabular impingement, is a common condition that can occur in people of all ages. Although, it is found often with people under 40 as a potential cause of early arthritis. If left untreated, hip impingement can be quite painful and worsen over time.

What is hip impingement?

The disorder is caused by excess bone and, therefore, lack of space between the neck of the femur and the rim of the socket. This lack of space causes the neck and rim of the socket to rub together, particularly when the hip is flexed, which leads to pain and, potentially, early onset of arthritis.

Types of hip impingement

Three different types of hip impingement can occur:
  • Pincer impingement
If the front of the hip socket (acetabulum) extends out too far, the neck of the femur, may bump into the rim of the socket during hip movements. This overgrown bone puts added pressure to the labrum (tissue surrounding the hip socket). This wear and tear can cause inflammation and lead to holes being formed within the hip joint cartilage.
  • Cam impingement
In this type of impingement, the bone around the head of the femur, which is normally a round ball shape, is misshapen. The abnormal shape grinds the cartilage that lines the hip socket and may cause it to peel away from the bone. The labrum also can become worn or torn.
  • Combined impingement
This simply means that pincer and cam forms of hip impingement are present.

What are the symptoms?

The primary symptom is pain in the hip area during or after the hip has been in a flexed position, such as running, jumping or sitting for long periods. It is possible to have the disorder for years without experiencing any pain initially. However, as time goes on, symptoms may worsen and the pain you may experience could worsen.

How is it treated?

Your doctor may begin treatment by recommending prolonged periods of rest to the impacted area, working with a physical therapist to strengthen the muscles around the hip, and taking anti-inflammatory and pain medications. If your impingement is still causing pain or limiting movement in everyday activities, an orthopedic surgeon may recommend arthroscopic or open surgery. During an arthroscopy, miniature instruments are inserted into small incisions made in the hip. Then the head of the femur and/or the socket are reshaped by removing excess bone. In more severe cases or if other repairs are necessary, an open surgery may be required to repair the impingement. In this procedure, the head of the femur and/or socket also are reshaped by removing excess bone, but a large incision is made to access the hip. If the impingement has progressed to significant arthritis, a joint replacement might be considered.
If you're concerned you may have hip impingement or want to learn more, contact your doctor or visit our Marshfield Clinic Health System orthopedics webpage.