Femoro acetabular impingement (FAI) can be treated using preventive measures to stop the underlying structural abnormalities in the hip-joint causing osteoarthritis. Once arthritic changes have already started, the main option for pain relief is hip replacement surgery.
Please note: We accept out-of-network insurance benefits (we will contact your insurance company and submit for you). FAI surgery consists of correcting the anatomical deformity, cam or pincer, but also of repairing the damage that has occurred to the articular cartilage and to the labrum.
It’s hard to believe that I had such a major surgery and with virtually no down time. Dr Davidovitch is personable and answers all of your concerns – but most of all he is an amazing surgeon. I was put out at 3:05 woke up at 4:20 and was walking around the nurses station at 5:40. I came home with a cane and used it for one day! My family and friends could not believe it when they saw me two days post op! Please put your faith in this incredible surgeon! ~ Healthgrades
What is femoro acetabular impingement (FAI)
FAI is a hip condition which describes a mechanical mismatch between the ‘ball’ and the ‘socket’ of the hip. There are two described types of impingement:
- ‘Cam’ type impingement describes a ‘bump’ on the surface of the femoral head (ball) which jams on the rim of the (acetabulum) socket. This type typically affects younger athletic men (common).
- ‘Pincer’ type is essentially a over deep acetabulum (socket) which restricts the movement of the femoral head (ball). This typically affects middle-aged women (less common).
- Combined – Patients can have both cam and pincer impingement at the same time.
Treating femoro acetabular impingement (FAI) with surgical intervention:
Whether you will need surgical treatment depends to a large degree on the type of FAI you have, the amount of deformity and the presence of arthritic change. Surgical treatments include:
- Arthroscopy (scope) – Arthroscopy is performed through small incisions in the skin to allow a camera to see the structures within the hip. This procedure address the labrum, the femoral head deformity and/or an abnormally shaped acetabulum.
- Open surgical dislocation – The blood supply to the hip is preserved by the NYC orthopedic surgeon while dislocating the ball from the socket. The procedure allows increased exposure to correct the deformities of the ball or socket.
- Osteochondroplasty – Excess bone on the femoral neck is removed in order to re-establish a round femoral head (ball) and a normally shaped socket.
- Total hip replacement – Total hip replacement A total hip replacement is a surgical procedure in which the arthritic or damaged joint is removed and replaced with an artificial joint (prosthesis).
In the majority of hips with FAI we find both a cartilage and a labrum lesion. The most common labral tear is a detachment. In many patients, correcting the underlying problem can be performed during the same surgery as one to repair the labrum, cartilage or bone. There are several surgical treatment options that the board certified surgeons of Orthopedic Hip Surgeons of NYC can employ to reduce hip pain symptoms, depending on the source of the pain:
- If the patient has a cam deformity the orthopedic hip surgeon can trim the bone away to make the head smoother and rounder.
- A torn labrum can be treated by trimming away some of the loose edges. In some patients it may have come completely loose and needs to be reattached to the back of the bony rim of the acetabulum.
- Articular cartilage damage can be removed but if there is exposed bone, this may need further repair.
- Exposed bone is treated by making a series of tiny holes in it to stimulate repair of the cartilage, which is known as a micro-fracture technique.