Hip impingement surgery

There are two types of hip impingement:

Cam: When the femoral head or 'ball' of your hip has thickened, meaning it isn't perfectly round, doesn't fit your hip joint and causes friction with your acetabulum or 'socket'

Pincer: When your acetabulum extends too far over your femoral head, causing the cartilage to get 'pinched' between the socket rim and front of the femoral head

Both types can occur together and cam and pincer-type femoroacetabular impingement treatments are generally the same. If you need an operation, your surgeon will remove the parts causing the abnormal contact and pain in your hip joint.

Hip impingement surgery aims to correct abnormal bone contact in your hip and reduce cartilage damage by reshaping the joint. Your consultant will discuss likely FAI surgery outcomes with you. Key benefits are typically:

• Reducing or eliminating pain and stiffness in your hip and groin
• Improving the range of movement in your hip joint
• Treating the clicking within the joint that some people experience
• Getting you back to exercise and daily activities Improving your quality of life
• Possibly reducing your risk of developing hip arthritis

Femoroacetabular impingement arthroscopic surgery is also a minimally invasive procedure. It involves very small incisions that minimise damage to nearby muscle and soft tissue. This means FAI hip surgery recovery is quicker and less painful than more invasive techniques to treat other chronic hip conditions.

Arthroscopic hip impingement surgery is a common, safe and effective procedure. As with all surgeries, there are some potential risks and side effects that your consultant will explain to you, relevant to your condition. Your surgical team will also take steps to minimise these risks.

Complications can include:

• Initial pain, stiffness, numbness or swelling in your hip, groin and/or thigh
• Infection at the point of incision
• Blood clots known as deep vein thrombosis (DVT)
• Poor reaction to anaesthesia, such as sickness

Your consultant will explain the procedure to you and answer any questions you may have. They'll let you know how best to prepare for surgery based on your condition, which may include:

• Trying to maintain a healthy weight
• Avoiding smoking
• Remaining active, possibly including doing specific exercises for your hip
• Arranging for help with travel and tasks such as shopping after surgery
• Making your home as comfortable and easy to get around as possible
• Avoiding eating and drinking for a certain amount of time before surgery

Your consultant may request an X-ray, CT or MRI scan to help visualise your hip joint before the procedure.

Arthroscopic hip impingement surgery is usually done under general anaesthetic, meaning you'll be asleep during the procedure, or regional anaesthetic, numbing you from the waist down without putting you to sleep. Your surgeon will make small incisions in your hip and insert surgical instruments including an arthroscopic camera, a tiny device that sends a live view of the inside of your hip joint to a monitor. They may also insert fluid into your hip joint to wash it out and expand it for a better view.

They'll then remove some of the cartilage or bone to reshape the joint surface, a process known as osteoplasty, and restore a better fit between its components. This may involve cutting away excess bone growth from the femoral head or the rim of your acetabulum, depending on your type of impingement. Your surgeon may also repair any cartilage damage during the procedure, before stitching up the incision. The whole procedure usually takes 1-2 hours.

Your hip impingement surgery recovery timeline will be personal based on factors such as your age, fitness level and the nature of your operation.

You'll usually be cared for in hospital overnight after your procedure. Your consultant will let you know how to care for your hip at home and manage pain in the days and weeks following surgery. You might need to use crutches for a short period to keep weight off your hip. You will also have a follow-up appointment to remove your stitches and dressing and check on your progress.

An onsite physiotherapy team will introduce you to exercises that help rebuild strength and range of movement. They'll also let you know when you can get back to your usual routine, including work or exercise, which will vary depending on their impact levels.

As a rough guideline, most people can resume their normal activities without pain around six to eight weeks after surgery. Full recovery, such as unrestricted exercise, can take four to six months. We'll support your FAI hip surgery recovery and aim to get you back to doing the activities you enjoy as soon as possible.

Your hip impingement syndrome may be treatable with non-surgical options such as:

• Resting and limiting strenuous activities that involve bending and rotating your hip
• Taking painkillers and anti-inflammatory medication
• Physical therapy to strengthen the muscles around your hip

Your GP or orthopaedic consultant may recommend trying these before moving on to other femoroacetabular impingement treatment options. This can include using therapeutic injections to relieve pain while confirming whether it is coming from your hip or lower back and abdomen. If your symptoms persist, you may then be recommended surgery.

In some cases, you could need a more extensive open surgery rather than a keyhole procedure. This involves larger incisions and a longer hospital stay and recovery. If you’ve already lost a lot of cartilage in your joint, you may be recommended hip replacement surgery instead.