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Femoroacetabular impingement (FAI) Treatment Options

Treatment options for FAI depend on the severity of the condition and the symptoms experienced by the patient. 

What are the non-surgical treatments for symptomatic femoroacetabular impingement?

Dr. Godin may initially recommend a trial of non-surgical treatments including:

  • Rest, icing, activity modification, and anti-inflammatory medications
  • Physical therapy to improve hip range of motion, strengthen hip muscles and reduce symptoms.
  • Intra-articular injections of steroids, platelet rich plasma, or stem cells may be offered to treat pain that interferes with sleep and limits the ability to perform daily life activities or participate in physical therapy.
  • In some cases, non-surgical management may be enough to manage symptoms adn prevent further damage.

When conservative treatment fails to relieve pain and improve function, and imaging reveals joint damage, surgery may be necessary.

What are the surgical treatment options for femoroacetabular impingement?

  1. Hip Arthroscopic surgery: Arthroscopic surgery is a minimally invasive surgical procedure that involves inserting a small camera and instruments into the hip joint through small incisions. Hip arthroscopy is used to reshape the bones, and repair cartilage and labrum damage. During this procedure, Dr. Godin can clean up the damage to the labrum and cartilage and correct the bony abnormalities by trimming the bones. It is designed to reduce pain, increase range of motion, and enable athletes to return to their sport by restoring normal anatomy. Arthroscopic surgery is typically recommended for patients with more severe or persistent symptoms.
  2. Open surgery: Open surgery may be required in rare cases when arthroscopic surgery is not feasible or has failed. Open surgery may be needed in complex cases, where in addition to femoroacetabular impingement there is hip dysplasia or another co-occurring disorder. Open surgery involves a larger incision and may require a longer recovery time.
  3. Periacetabular osteotomy (PAO): PAO is a surgical procedure that may be used to treat certain types of FAI. PAO involves cutting and repositioning the acetabulum, the cup-shaped socket of the hip joint, to improve the coverage of the femoral head and reduce impingement. PAO is typically recommended for younger patients who have hip dysplasia, which means that the hip socket is abnormally shallow, and this leads to more significant impingement. It is not typically used for patients with cam-type or mixed-type impingement.
  4. Femoral osteotomy: Femoral osteotomy is another surgical procedure that may be used to treat certain types of FAI. It involves cutting and repositioning the femur (thighbone) to improve the alignment and reduce impingement. Femoral osteotomy may be recommended for patients with cam-type impingement, where the femoral head is abnormally shaped and causes damage to the acetabulum.Femoral osteotomy is a more invasive surgery than PAO and may require a longer recovery period.
  5. Surgical hip dislocation (SHD): This is a procedure that is used to access the hip joint for the treatment of certain conditions, including FAI. SHD involves dislocating the hip joint to allow the surgeon to access and repair damaged structures within the joint. SHD is only used for certain cases of FAI, particularly where there is significant bone deformity or damage to the labrum.
  6. Hip replacement surgery: In severe cases where the joint damage is extensive, hip replacement surgery may be the best option. This involves replacing the damaged hip joint with an artificial joint.

The goal of surgical treatment is hip preservation and pain relief. It is designed to improve hip mechanics before damage has occurred, to delay or prevent the onset of arthritis and the need for a hip replacement.

Dr. Jonathan Godin is a renowned board-certified orthopedic surgeon and a leader in sports medicine. He received fellowship training in advanced arthroscopic and reconstructive surgical techniques for the treatment of complex orthopedic and sports related injuries at the distinguished Steadman Clinic in Vail Colorado. Contact Dr. Godin at his Vail, Frisco, or Edwards, Colorado office to schedule a consultation to receive the correct diagnosis and all your treatment options.

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