Treatment of Femoroacetabular Impingement with Arthroscopy

Treatment of Femoroacetabular Impingement with Arthroscopy

Femoroacetabular impingement is a significant orthopedic condition causing hip pain and restricted movement. Arthroscopic surgery, due to its minimally invasive nature, is a currently preferred effective method for treating this condition. In this article, you can find up-to-date information on the characteristics of femoroacetabular impingement, treatment procedures with arthroscopy, and the postoperative period.

Femoroacetabular impingement (FAI) is one of the mechanical problems of the hip joint, commonly seen especially in young and active individuals. This condition causes pain in the hip, restriction of movement, and over time, cartilage damage which can lead to early osteoarthritis. Femoroacetabular impingement typically arises due to abnormal contact between the femoral head and the acetabulum (hip socket), which can cause labral tears and cartilage injuries.

What Is Femoroacetabular Impingement?

The hip joint consists of the spherical femoral head moving within the acetabulum. Femoroacetabular impingement occurs due to deformities in the shape of the femoral head and acetabulum, causing abnormal contact between them. This impingement is mainly classified into two types: cam type and pincer type.

In cam-type impingement, a protrusion forms on the neck region of the femoral head, damaging the labrum and cartilage during contact with the acetabulum.

In pincer-type impingement, there is excessive bone growth on the edge of the acetabulum which compresses the femoral head.

Some patients may exhibit both types simultaneously, referred to as the combined type.

Arthroscopic Surgical Treatment Methods

In recent years, arthroscopic interventions have become the gold standard for the surgical treatment of femoroacetabular impingement. Arthroscopy involves accessing the joint through small incisions using a camera and miniature surgical instruments. This technique offers advantages over open surgery, including less tissue damage, reduced pain, and faster recovery.

The objectives of arthroscopic surgery include correcting abnormal bone protrusions (femoro- and acetabuloplasty), repairing or reconstructing the labrum, and treating cartilage damage if necessary.

During surgery, the protrusion on the femoral neck is trimmed to normalize its shape, excess bone on the acetabulum edge is removed, and tears in the labrum are repaired with sutures.

These procedures eliminate mechanical impingement within the hip joint, relieve pain, and restore mobility.

Preoperative and Postoperative Periods

Before arthroscopic treatment, detailed patient examination and imaging methods such as MRI and X-rays are used to assess the type and severity of impingement. Preoperative preparations and patient education are important.

Post-surgery, patients can typically begin returning to normal activities within 1-2 days. However, a structured physiotherapy program is essential for full recovery and restoration of strong hip function. Physical therapy focuses on strengthening the muscles around the hip and maintaining joint range of motion.

Pain control, infection prevention, and avoiding excessive stress during early recovery are also critical.

Following arthroscopic surgery, some patients may use crutches for 4-6 weeks. Full recovery and return to sports activities usually range between 3-6 months, depending on the patient's condition.

Advantages and Risks of Arthroscopic Treatment

Advantages of arthroscopic surgery include its minimally invasive nature, shorter hospital stay, less postoperative pain, early mobilization, and quicker return to work and social life.

However, as with any surgical procedure, arthroscopy carries some risks such as infection, nerve injury, bleeding, joint stiffness, and persistent symptoms due to incomplete treatment. These complications are rare.

Proper patient selection, surgeon experience, and an appropriate rehabilitation program minimize risks and enhance successful outcomes.

Arthroscopy holds a crucial role in modern orthopedics for effectively relieving pain and preserving function in the treatment of femoroacetabular impingement. Early diagnosis and timely intervention prevent more severe hip joint problems and improve patient quality of life.