FEMOROACETABULAR IMPINGEMENT osgpc.com Hip Anatomy underlying impingement. Isolated arthritis hip problems should be • Femur: Head and neck labral tears are common and may performed. The following studies regions not cause pain. Failure to may be recommended: • Acetabulum: Socket on pelvic recognize and treat underlying • X-ray - the gold standard for ring impingement may lead to worse making diagnosis, minimal • Labrum: Cartilage ring on rim outcomes. radiation exposure of acetabulum • MRI - can show tears in the - Provides mechanical support labrum and other injury - Seals joint like a gasket NORMAL CAM patterns, no significant radiation • Articular Cartilage: Smooth risk gliding surface • CT Scan - provides the greatest - Worn out in arthritic hips detail about bone structure, radiation exposure is higher than x-ray or MRI • Injections - numbing injections Pelvis PINCER MIXED can be helpful in determining the location of pain while cortisone can provide pain relief Labrum Femoral Head Acetabulum (Hip Socket) Who is at Risk? Impingement most commonly aects young athletes in sports Femur that require forceful, repetitive hip movements. However, patients of all ages as well as non -athletes What are the Treatment Options? What is FAI? can be aected. • Anti-inflammatory and pain Impingement occurs when there is meds abnormal contact between the What are the Symptoms? • Rest and/or activity femur and acetabulum during hip • Deep, sharp anterior hip/groin pain modification range of motion. This can be due • Worse with quick turns/pivoting • Physical therapy to a head that is not perfectly • Difficulty with prolonged sitting round (CAM) or a socket that is • Pain on exam with hip flexion and When Should Surgery be too deep (PINCER) internal rotation Considered? • Failed non-surgical treatments What Causes a Labral Tear? What Should be Done if • Unable to perform desired Tears are most often the result of Impingement is Suspected? athletic activities repetitive hip flexion or twisting An evaluation by a medical • Pain with normal day to day motions in patients with provider with experience in non- activities HIP ARTHROSCOPY PATRICK W. KWOK, MD FEMOROACETABULAR IMPINGEMENT (FAI) Hip Arthroscopy Basics Practice Overview Dr. Kwok is a board • Hip joint (ball and socket) certified-orthopaedic separated by pulling traction surgeon, fellowship- through foot/leg trained in sports • Small instruments (camera, medicine. He shaver, burr, sutures) inserted specializes in through 1 cm incisions shoulder, elbow, and knee surgery. He also • Surgery usually takes 1.5-2 hours has a special interest • Most patients go home day of in hip arthroscopy, surgery particularly in the • Crutches for 2-4 weeks treatment of • Return to sports at 4-6 months femoroacetabular impingement. Dr. Kwok is a fellow of the American Academy of Orthopaedic Surgeons, a diplomate of the American Board of Orthopaedic Surgery, and a member of the American Orthopaedic Society for Sports Medicine. He currently is one of the team physicians for the Bridgeport Soundtigers (the AHL affiliate for the UNDERSTANDING New York Islanders), Fairfield University, and Fairfield High School. He was the HIP IMPINGEMENT, former head team physician for the LABRAL TEARS, AND Bridgeport Bluefish of the Atlantic League of Professional Baseball. HIP ARTHROSCOPY Pre-Op & Post-Op X-rays Education Medical School: Albert Einstein College of Medicine, Bronx, NY. Orthopaedic Surgery Residency: University of Connecticut School Medicine, Farmington CT. Sports Medicine Fellowship: New England Baptist Hospital, Boston MA. Appointments Reprinted with permission from Twin Cities Orthopaedics. (203) 337-2600 x 1114 Special thanks to Dr. Chri stopher Larson, his associates, Website fellows, and residents. www.osgpc.com www.osgpc.com.