Hip Impingement (FAI) Specialist

What is hip impingement?

Hip impingement — also called femoroacetabular impingement (FAI) — is a condition that is caused by an abnormally shaped ball or socket (or both). This extra bone (bone bump, bone spur) leads to a “square peg in round hole”. This increased friction and is the most common cause of hip labral tears and hip arthritis. This may cause damage to the hip joint over time and is characterized by:

• Groin (or hip) pain after sitting or standing for long periods
• Groin (or hip) pain during deep flexion or hip rotation
• Snapping or popping or clicking in the front of the hip
• Pain radiating into the thigh or buttocks
• Groin (or hip) pain during deep hip stretches
• Stiffness of the hip, decreased motion
• Instability of the hip, with fear of “giving out” or “giving way”

Hip impingement symptoms are typically aggravated by physical activity, such as sports, exercise, and walking. The pain can fluctuate from mild to moderate to severe, and it can increase your risk of arthritis and chronic pain, if left untreated.

What causes hip impingement?

Hip impingement occurs when there is abnormal contact and wearing between the ball and socket of the hip joint. This may be due to:

• Misshapen femoral head (cam)
• Deformed femoral neck (cam)
• Hip socket that covers too much of the femoral head (pincer, subspine)

These anatomical abnormalities may be present from birth or may develop over time. Common activities that can cause pain due to impingement include football, baseball, basketball, soccer, tennis, hockey, lacrosse, golf, yoga, pilates, ballet, dancing, mixed martial arts, gymnastics, high-intensity interval training, running, cycling, spinning, swimming, duathlon, triathlon, Olympic weight-lifting.

It’s also possible that trauma or a specific injury to the hip may cause impingement. Perthes disease and slipped capital femoral epiphysis (SCFE) may also contribute to hip abnormalities, especially in children.

How is hip impingement diagnosed?

If hip impingement is suspected, Dr. Harris completes a comprehensive consultation and physical exam to understand your symptoms, activities that aggravate your discomfort, and any potential traumatic factors. Dr. Harris includes a thorough series of orthopedic tests to assess the range of motion and function of your hip joint.

After your exam, Dr. Harris takes X-rays or may order an MRI or CT of your hip. Imaging is used to show any anatomical changes in your hip socket or femoral head and possible signs of arthritis or damage caused by hip impingement.

Based on your exam and imaging, Dr. Harris diagnoses the cause of your symptoms and outlines a treatment plan.

How is hip impingement treated?

To treat hip impingement, Dr. Harris performs a minimally invasive surgery called hip arthroscopy. During the surgery, he uses tiny tools to perfectly reshape the ball and socket portions of your hip (impingement correction). Almost always, a labral tear is also diagnosed and repaired at the same time. The operation is normally an outpatient procedure, generally coming in and going home on the same day. Outpatient physical therapy usually begins within the first day or two following surgery. Afterward, you recover with active physical therapy for about three months before returning to your normal activities.

Dr. Harris is one of very few surgeons in the United States and the only surgeon in Houston to perform “postless” hip arthroscopy, which eliminates the risk of perineal pain, pudendal nerve injury, and a variety of other traction-related complications that are not uncommon during and after hip arthroscopy.

Dr. Harris performs over 300 arthroscopic hip surgeries per year and has performed over 1,500 in his career.

If you have signs of hip impingement, set up a consultation and exam online or by phone with Joshua D. Harris, MD.