What is Hip Impingement?
Hip impingement is a grouping of disorders in which there is limited space
within the hip for the soft tissues that line the bones. This can be due to
irritation of the cartilage, tearing of the labrum (deepening cartilage), or
limitations in the motion. This spectrum of diseases can affect day-to-day life
or sports. Typically, pain occurs during activity. These disorders can often be
treated with hip arthroscopy.
This is NOT arthritis. Arthritis or wearing away of the cartilage is
typically painful at all times including rest and sleep. Hip arthroscopy is not
an effective treatment for hip arthritis.
Hip impingement comes in three common varieties: cam, pincer, and combined.
Cam impingement is an extra “bump” of bone on the ball of the hip joint. (See
large arrow, Figure 1) This decreases the smoothness of rotation of the hip.
Pincer impingement is an extra boney lip on the cup of the hip socket. (See
small arrow, Figure 1) This creates a pinching effect of soft tissues in certain
motions during activity. The most common type, however, is a combination of both
of these entities.
Figure 1: Cam lesion near ball of hip (large arrow), Pincer lesion
The combination of these changes around the hip can cause pain, tear
cartilage, and limit motion. There is also concern that these changes and the
symptoms created may lead to the acceleration of arthritis. Surgery can be
helpful in eliminating symptoms and hopefully, create a more normal hip to
diminish the risk for arthritis.
Figure 2: Hip labral tear arrow with extra bone on the acetabulum
(socket) of the hip joint
Hip arthroscopy is an outpatient, minimally invasive surgery that can help
with these changes. (See figures 3 and 4) Cartilage or labrum tears can be
repaired, and extra bone can be eliminated. These changes can improve symptoms
and increase activity through small incisions compared to the large incision
technique of the past. Smaller incisions typically equate to shorter recovery to
Figure 3: Cam lesion being excised during surgery
Figure 4: Excising Cam lesion on x-ray
Recovery after hip arthroscopy is variable but typically consists of an
outpatient or same-day surgery. Most patients are on crutches 1-5 weeks
depending on the type of procedure done. Therapy begins the day after surgery
and usually lasts 3-4 months with decreasing frequency. Most patients are able
to get back to more normal activities including running and other sports around
the 4-8 month mark after surgery depending on the problems that are encountered
during surgery. Like any surgery, hip impingement surgery has risks that must be
considered and discussed with the surgeon.
If you have questions please feel free to contact me,
Eric Pifel, MD
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DISCLAIMER: This web site contains general medical information and
does not replace the medical advice of your physician. If you have questions
about your medical condition or exercises, ask your doctor or health care