Joint Preserving Surgery
Hip Dysplasia
Hip Impingement
Minimally Invasive Hip Surgery
Hip Impingement

Hip impingement, also known as femoro-acetabular impingement, is a common abnormality that has been appreciated only more recently, in the past 10 years. The problem affects mostly men and is probably responsible for the vast majority of men who have had or are in need of hip replacement surgery between the ages of 30 and 55.
Femoro-acetabular impingement occurs from a combination of abnormalities of both the ball (femoral head) and socket (acetabulum). On the ball or femoral side, there is usually very little clearance between the ball and neck of the femur in the front part of the joint. On the socket side, the socket is usually somewhat overdeveloped in the front and the socket is facing slightly the wrong way. These two problems combine so that the hip joint jams in the front when the hip is bent all the way forward. The problem may arise around the time of birth but is usually noticed by men more heavily involved in sporting activities. Hockey, football, soccer and long-distance running are sports have produced the highest incidence of patients with this condition and so it appears that these activities probably accelerate the problem.
If the hip has not degenerated too far, femoro-acetabular impingement can be treated by surgically dislocating the hip, trimming the excessive portion of the front of the socket, and reshaping the junction between the head and neck of the femur to provide greater clearance and relieve the impingement.
The effect of reshaping of the joint can easily be seen during surgery.  And although very little has been written about this problem to date (see references on femoro-acetabular impingement) ,identifying and treating femoro-acetabular impingement has proven very helpful if performed on the right hip at the right time.

 

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For more information about the clinical experience with these techniques, please view the following manuscripts (please note that these manuscripts are for educational purposes only and should not be reproduced without permission from the publisher):

Murphy SB, Tannast M, Kim Y-J, Buly R, Millis MB. Surgical Treatment of the Adult Hip for Femoroacetabular Impingement, Clinical Orthopedics and Related Research, December, 2004(PDF)

Tannast M, Kubiak-Langer M, Langlotz F, Puls M, Murphy SB, Siebenrock KA. Noninvasive three-dimensional assessment of femoroacetabular impingement. Journal of Orthopaedic Research. January, 2007.

Tannast M, Kubiak-Langer M, Murphy SB, Ecker TM, Puls M, Langlotz F, Siebenrock KA. Computer-assisted Simulation of Femoro-acetabular Impingement Surgery. In JB Stiehl, WH Konermann, RG Haaker, AM DiGioia (eds.): "Navigation and MIS in Orthopaedic Surgery", Berlin, Heidelberg, New York: Springer-Verlag. pp 448-455, 2006.