The hip joint consists of a ball and socket and is a very stable joint, allowing us to bear weight and participate in functionally demanding work and recreational activities. However, hip injuries are not uncommon, and can be very limiting when they do occur.
A relatively common condition is called femoroacetabular impingement (FAI), also known as hip impingement. In this condition, the ball of a patient’s hip hits up against (impinges on) the rim of the socket, causing pain. Certain variations in anatomy, such as a relatively deep socket or a slightly non-spherical femoral head, can predispose patients to impingement. Chronic impingement can lead to tearing of the hip’s labrum, which is a rim of cartilage, like a gasket, that runs around the edge of the joint. Over time, the torn labrum leads to changes in the wear patterns of the joint, potentially leading to premature arthritis of the hip and the need for hip replacement at a young age.
As with most injuries, the initial treatment for hip pain is a thorough physical exam to identify the specific problem and generally includes a period of rest. Physical therapy and anti-inflammatory medications may also be useful in some cases. If the pain persists, however, and is felt to be due to impingement and/or a labral tear, then surgical treatment may be recommended. Surgery, in most cases, can be done arthroscopically, meaning that the hip joint is approached through small incisions, about half an inch in length, that allow the surgeon to visualize the joint through a camera. The goal of surgery is to correct the anatomic abnormalities that are causing impingement, as well as to repair any tears of the labrum that might be present.
Most hip arthroscopies can be done on an outpatient basis, meaning that you go home the night of surgery. Depending on exactly what needed to be done, your surgeon may recommend that you wear a hip brace after surgery. You may also need to use crutches to avoid putting weight on the affected side for about a month. Return to work depends on the demands of your job, but most patients with a desk job can usually return to work in one to two weeks. You will need physical therapy after your surgery to regain strength, range of motion and function of your hip, and should expect full recovery to take at least 3 to 4 months.