Femoroacetabular impingement can be treated using preventive measures to stop the underlying structural abnormalities in the hip joint causing osteoarthritis. Once arthritic changes have already started, the main option is hip replacement surgery.

Early treatments for femoroacetabular impingement

There are several surgical treatment options that can reduce symptoms, depending on the source of the pain:

  • A torn labrum (the cartilage at the rim of the hip) can be treated by trimming away some of the loose edges. In some patients it may have come completely loose and needs to be reattached to the back of the bony rim of the acetabulum.
  • Articular cartilage damage can be removed but if there is exposed bone, this may need further repair.
  • Exposed bone is treated by making a series of tiny holes in it to stimulate repair of the cartilage, which is known as a microfracture technique.

The underlying hip abnormality can also be treated

If the patient has a cam deformity, when the head of the femur is misshapen, we can trim the bone away to make the head smoother and rounder. This is done by burring away the bone so that it can move much more easily within the hip joint.

In many patients, correcting the underlying problem can be done in the same operation as one to repair the labrum, cartilage or bone.

Hip replacement in young adults with femoroacetabular impingement

Once the hip joint has become damaged to such an extent that arthritic changes have occurred, early stage treatments are no longer effective. The best option for the patient is then to wait until they feel their symptoms have progressed to such a stage that they would like to have a hip replacement.

Patients are able to cope with mild to moderate pain for several years, maintaining good activity, and opt for surgery only when the pain increases or they start to feel that their activity is being curtailed.