What is Hip Impingement?

Hip impingement is essentially kind of a square peg in a round hole. It’s when the ball and socket joint of the hip actually have a point where they impinge, and that is where the bone of the femur hits up against the bone of the acetabulum, which is the socket side of that hip joint. And as you can see here, the impingement happens at a sooner time in the range of motion than when we have something like this, which has what we call a larger offset and we have more range of motion before we actually impinge on those bones and we flex the hip either forward or to the side. And so this hip impingement can cause pain, but it can also cause tearing of the labrum around the acetabulum. So, the acetabulum being the cup side of our ball and socket joint, has a piece of cartilage that runs around the socket that deepens the socket, it creates a more stable joint, and creates this suction seal that gives stability to the joint as well. And that can get torn, and that can be painful. And so, for this type of issue, one of the things we do is physical therapy. Physical therapy to help to engage the core muscles and the glute muscles in order to tilt the pelvis posteriorly a little bit, to allow for more motion of the hip before it impinges. Then, we also do anti-inflammatories to help calm down the inflammation, and we can do injections into the hip joint itself, if more of an anti-inflammatory effect is needed, something a little bit stronger with a steroid. And then if none of those help over the course of 3 months or so, then we consider going on to surgery. And surgery would be what we’d call a hip arthroscopy, and that entails 3 or 4 small poke holes in the side of the hip, where I arthroscopically reattach the labrum using sutures and then I get rid of the impingement where that might be, either shaving off bone from the femur here or off of the acetabulum here. And that way we get more range of motion in the hip without impingement, we repair the labrum, and then after the procedure, I close the capsule that surrounds the hip joint to give more stability to the hip joint once the procedure is done. After the procedure, there are some range of motion limitations for a period of time, but most people feel that they have a resolution of their symptoms relatively quickly right after surgery.


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