FEMOROPLASTY

Femoro-acetabular impingement (FAI) is a condition caused by misshapen bone(s) in the hip in which abnormal contact between the bones may damage the labrum (rim of fibrocartilage surrounding the cup/acetabulum) and the articular cartilage that lines the bones. CAM impingement is a type of impingement that occurs as a result of a misshapen femoral head. Instead of being round, the femoral head has a “bump” on one side, which leads to abnormal contact between the ball (femoral head) and the socket (acetabulum) with hip motion.

Patients with impingement who fail non-surgical management may require surgery. If surgery is necessary, Dr. Welch usually recommends an arthroscopic approach to the hip using two or three small incisions. During surgery, Dr. Welch introduces a camera into the hip through one incision and surgical instruments though the other incisions.

Dr. Welch then performs femoroplasty for patients who have CAM impingement. During surgery, Dr. Welch uses an instrument to shave away the abnormal “bump” at the base of the femoral head. During the procedure, Dr. Welch uses x-rays for guidance as he re-contours the shape of the femoral head. By restoring the normal shape at the base of the femoral head, Dr. Welch may eliminate the painful symptoms related to impingement.

Postoperative Plan

Following surgery, Dr. Welch recommends a guided physical therapy program with a licensed physical therapist. Early motion following surgery is very important, and Dr. Welch recommends that each patient either use a stationary bike or a continuous passive motion machine daily. Dr. Welch also recommends limited weight bearing and crutch use for 4-6 weeks after surgery. Dr. Welch may also recommend the use of a brace for approximately two weeks to help protect the hip.

Following surgery, Dr. Welch prescribes appropriate pain medication as well as an anti-inflammatory medication. Anti-inflammatory medication (such as Naprosyn) is important because it can help eliminate pain and also may prevent the formation of abnormal bone (heterotopic ossification).