Femoroacetabular Impingement (FAI) Treatment
Treatment for FAI starts conservatively with rest, activity modification and anti-inflammatories such as ibuprofen or naproxen. Physical therapy is prescribed to help strengthen hip muscles and improve the support of the hip. A numbing medicine and corticosteroid injection into the hip joint can help reduce pain and inflammation in patients whose hip is extremely irritated.
If these initial conservative treatment options do not improve the pain and function of the hip, your physician may pursue surgical treatment options. For FAI, this is usually addressed with a hip arthroscopy, or sometimes with a surgical hip dislocation.
Hip arthroscopy involves making small incisions around the hip that allow for a small camera and surgical instruments to be inserted and repair the labrum and remove the excessive bone. If the deformity is too complex to perform hip arthroscopy, then a surgical hip dislocation is performed. This entails an incision on the side of the hip followed by dislocation of the hip to access the labrum and excessive bone.
What can I expect after surgical treatment?
The type of recovery after surgical treatment will depend on the procedure you receive. For patients who undergo hip arthroscopy, crutches are used for two to three weeks after surgery to allow for the labrum to heal.
Recovery after a surgical hip dislocation usually takes longer, as this is a more complex procedure. Patients will need physical therapy for three months following surgery to help increase strength in the hip muscles. About three months following surgery, patients can begin running. At four months, patients can return to their sport of choice. To prevent reinjury of the hip or another joint injury, the physical therapist will work with patients to determine whether the hip and conditioning are ready for competition. No two hips are the same, and the recovery may take longer for some patients.
Outcomes following treatment for FAI
About 85 percent of patients who undergo surgical treatment for their condition return to their previous activity level. The goals of surgery are to decrease pain, improve the function of the hip, and delay or prevent the progression of osteoarthritis.
For patients older than 40 and who have had symptoms for more than two years, the results following surgery are less predictable. For these patients, the condition of the cartilage in the hip joint may have become more advanced and cannot be fixed with hip preservation surgical techniques. The surgeon and patient should discuss their expectations prior to surgery so that a successful outcome can be reached.