Femoroacetabular impingement (FAI) is a condition where the hip bones are abnormally shaped from birth. This causes them to not fit together perfectly, and thus they rub together, causing damage to the joint between them, and possibly inducing osteoarthritis. Surgery is required when FAI causes symptoms that cannot be relieved by nonsurgical treatment. This is usually done as an arthroscopic procedure, where a small camera and other instruments are inserted through small incisions in the hip. Occasionally an open procedure may be necessary if the damaged area is larger. During the procedure, any damage to the labrum or cartilage is repaired, and the surgeon will correct the impingement by shaving down the femoral head and trimming the rim of the acetabulum (the hip socket).
Who is a candidate?
Candidates for FAI surgery have FAI that causes pain in the groin area and/or pain from twisting, turning and squatting. They should have completed nonsurgical treatment with no successful alleviation of symptoms.
Who is not a candidate?
Patients whose FAI is asymptomatic or whose FAI symptoms can be relieved with nonsurgical treatment are not candidates for FAI surgery.
Like other surgeries, FAI surgery requires a complete physical examination with your primary care provider before surgery. Depending on the severity of the FAI damage and symptoms, you will either go through nonsurgical treatment first or be immediately referred for surgery. You should inform your orthopedic surgeon of any medications or supplements you take, and comply with certain general surgery procedures such as preoperative blood testing and possible cessation of smoking or use of pain relievers and anti-inflammatory drugs one week prior. You will likely be asked to stop eating or drinking the night before the surgery.
After the surgery, patients typically use crutches for the first 1-2 weeks to minimize weight- bearing. Depending on the amount of bone removed and whether or not the labrum was torn and repaired, recommendations for postoperative care will vary. However, in general, activity restriction prior to beginning a regimen of physical therapy will occur to let the area heal. After 6 weeks of physical therapies, most patients are capable of resuming normal activity, but it may take 3-6 months to experience no soreness or pain following physical activity.
As with any surgery, there are risks of complications related to bleeding, blood clots, infection or adverse reactions to anesthesia. Other known complications include post-surgery pain in the hip and thigh, and injury to nerves or blood vessels.
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