Femoral acetabular impingement (FAI)

Sometimes called the “ball and socket” joint, your hip joint includes a rounded head of the femur (thighbone) that fits into the acetabulum (a socket in your pelvis). Your femur and acetabulum are connected by strong bands of tissue called ligaments. The muscles around the joint help to stabilise your hip. A layer of cartilage cushions the ends of  the bones allowing for smooth movement in the joint.

In some cases Femoral acetabular impingement (FAI) results in damage to the cartilage within the joint or tears in the labrum (ring of tissue holding your femur in place).

Although anyone can develop FAI, it is often seen in young, athletically active patients.

• Symptoms of FAI can include:
• Groin or hip pain including restricted hip movement
• Pain following participation in sporting activities
• Pain after sitting for long periods
• Clicking or locking sensation with the hip joint
• Low back or sacroiliac joint pain

How is FAI diagnosed?

Your consultant will take a full medical history. They will examine the movement of your hip joint by manipulating your hip joint. X-rays can usually confirm FAI. In some cases an MRI or CT scan may be ordered.

Treatment for FAI may include rest and the use of pain killers or anti-inflammatory medication. However this approach does not address the uneven bone surfaces with your hip joint. Your consultant may recommend minimally invasive arthroscopic surgery.

What happens during hip arthroscopy?

Arthroscopy is very often performed as a day case with the patient under general anaesthetic. In some cases spinal anaesthetic and light sedation may be used. Your anaesthetist will discuss the options with you. The operation takes between 30 and 90 minutes.

You will be put on to a traction table (a type of operating table), which pulls firmly on your leg. This pulls your hip joint apart a little, so your surgeon can see into the joint. They will insert a camera through one or more small cuts around your hip. Other small incisions will be made to introduce instruments to remove any diseased tissue or bone and repair any tears. Your wounds will be closed with stitches or staples.

Immediately after your operation you will be taken to a recovery area. Our healthcare team will monitor you and give you medication to relieve any pain.

A physiotherapist will visit you to help you begin to move about on your own. You may need to use a walker or crutches. You may be given gentle exercises to help build your muscle strength.

In some cases hip arthroscopy is performed as a day case meaning you can go home when you have recovered from the anaesthesia. Your consultant may require you to stay overnight.

Going home after hip arthroscopy

You will not be able to drive yourself home so please arrange for someone to take you on the day of discharge.

You should take it easy for a few days. Please follow any instructions to restrict weight bearing on your operated side. You may have a few small stitches on each wound, which should be left in place until your follow-up appointment at the hospital, around 10-14 days later. Continue to take any pain relief medication if needed. Continue any exercises as instructed by the physiotherapist.

Full recovery can take 3-4 months. Discuss any return to work and resuming any sports with your consultant.

Most people make a good recovery from hip arthroscopy. As with any surgical procedure there could be complications including:

• Pain
• Bleeding
• Infection on the wound 
• Scarring
• Difficulty passing urine
• Blood clots (deep vein thrombosis – DVT)

Specific complications of hip arthroscopy may include:

• Nerve damage
• Infection in the hip joint
• Tendon damage
• Localised stiffness or pain
• Why not print this treatment page so you can discuss any concerns you have with your consultant?