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 acetabulum/cup) and the articular cartilage that lines the bones. Pincer Impingement is a specific type of FAI. This type of impingement occurs when the hip socket (acetabulum) is deeper or extends further than normal around the ball (femoral head).
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 instruments into the hip though the other incisions.
Dr. Welch then performs acetabuloplasty for patients who have pincer type impingement. During surgery, Dr. Welch uses an instrument to remove a bone spur off of the acetabulum of the hip joint. Dr. Welch then uses x-ray for guidance to re-contour the shape of the acetabulum and therefore restore the appropriate shape of the acetabulum. By restoring the normal shape of the hip joint, Dr. Welch may eliminate the painful symptoms related to impingement and potentially prevent further injury to the cartilage and labrum.
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 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).