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 osteoarthritis
of the hip in men who are treated by total hip replacement
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 notice by men who are involved in
sports to a greater degree than the average person. Hockey,
football, soccer and long-distance running are the sports
that patients have been involved in so it seems 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 give the joint more clearance and relieve the impingement.
The effect of this reshaping of the joint can easily be
seen at the time of surgery when the joint is opened. There
has been very little written about this problem thus far (see
references on femoro-acetabular impingement) but it has been
shown to be 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):
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