Dr. Sanjeev Bhatia is an orthopaedic specialist with Mercy Health. He treats a variety of sports medicine injuries and has office hours in Blue Ash and Montgomery and has written this piece on hip pain:
The hip is a ball and socket joint that allows for remarkable leg range of motion in a variety of sports. Unfortunately, sometimes hip joint pain can limit athletic performance due to a common condition called femoroacetabular impingement, or FAI for short.
FAI is a common condition where the femoral head (the ball), acetabulum (the socket), or both do not fit normally in place due to an alteration in the shape of the femoral head shape or rim of the acetabulum. The result is increased contact (impingement) as the hip is placed through a range of motion. Many athletes with FAI complain of pain in the front of the hip or groin during sports, after prolonged sitting or any activity that requires deep flexion or rotation of the hip. Sometimes, there is a popping or clicking in the front of the hip. FAI is diagnosed with a simple clinical visit which includes a hip examination, along with imaging studies such as X-ray and MRI.
Diagnosis and treatment: The first step in treating FAI is usually quite conservative. Rest from the sport or activity causing the pain, as well as anti-inflammatory treatment can significantly control the symptoms. Physical therapy to correct weakness or imbalance in the hip and core musculature is also usually prescribed. The nonsurgical approach can be successful in some cases. However, there are some cases where bony joint asymmetry is simply too much and the impingement will continue to cause pain and joint degradation when the young athlete attempts to return to sports. In those cases, arthroscopic surgery can be done.
What if conservative measures don’t work? During hip arthroscopy, the goal is to tailor the procedure to the exact type of problem in each hip. For younger athletes I have a strong preference for performing the most conservative procedure that results in restoration of as close to normal anatomy as possible. This typically includes removal of the impinging bone spurs to restore the natural shape of the ball and socket, repairing the ring of tissue around the socket (called the labrum), and tightening loose ligaments. The surgery is done on an outpatient basis with patients returning home on the same day. For a typical FAI surgery, most patients can expect to be on crutches and in a hip brace for 2-3 weeks after surgery. Physical therapy is an essential component of recovery and usually occurs for 3-4 months postoperatively.
Outcomes and return to sports Fortunately, FAI in athletes has been studied very extensively. A review of our results from FAI surgery across all age groups showed that 90% of athletes from various levels including recreational, high school, college and professional have successfully returned to sports with excellent pain relief, function and performance. Most athletes undergoing hip arthroscopy are able to return to their pre-injury level in 4-6 months on average.
Dr. Bhatia is an orthopaedic specialist with Mercy Health. He treats a variety of sports medicine injuries and has office hours in Blue Ash and Montgomery. To schedule an appointment call 513-347-9999.