Anterior hip impingement

1) A LITTLE ANATOMY:

The hip joint involves the femoral head (sphere shape) and the pelvic joint cavity, or acetabulum (hemisphere shape). … The sliding and rolling of the femoral head in the acetabulum is facilitated by the cartilage that covers both bony surfaces.

 

2) WHAT IS THE ACL LESION, AND WHAT ARE THE DAMAGE MECHANISMS?

Anterior hip impingement, also called femoroacetabular impingement, refers to abnormal contact between the pelvis and the femoral neck.

This conflict is generally created during the hip flexion movement, causing pain and possibly leading to cartilage and labral lesions.

In the long term, the risk of developing early osteoarthritis is increased.

 

 

3) WHAT ARE THE LESION MECHANISMS?

This type of injury generally affects young active adults (20 to 50 years old), and most often occurs during sports practice.

There are two types of mechanisms:

The cam effect: linked to a deformation of the neck of the femur, it will promote lesions of the labrum and cartilage
The clamp effect: linked to a deformation of the actetabulum (pelvis covering too much), it will promote lesions of the labrum

 

4) WHAT ARE THE RISK FACTORS?

The exact causes of hip impingements are currently not clearly identified. Genetic factors are mentioned.

However, certain parameters can facilitate the appearance of symptoms:

Overweight
Strenuous physical activity, especially for sports involving excessive and repeated hip flexion
Hip pathologies dating from childhood (e.g. osteochondritis, etc.)

 

5) WHAT ARE THE SYMPTOMS?

Common symptoms include:

The pain, located in the fold of the groin, and spreading to the hip. It is described as deep and is accentuated in the position of hip flexion and during the practice of sport
Stiffness in the joint, but is not present in all cases of impingement
Feeling of hiding
Loss of mobility

 

6) IS IT SERIOUS?

The femoroacetabular impingement is not serious in itself. Its evolution is slow, and can be interspersed with acute painful phases.

In the event of a negative evolution, the pain caused may however become difficult to control.
It is also important to understand that there is no cure for this pathology. Once detected, the treatment put in place will essentially serve to slow down its development in order to learn to live with it and not have to give up daily physical activities.

 

7) IS SURGERY MANDATORY?

The treatment of anterior hip impingement depends on the symptoms and the condition of the hip joint: it can be medical (conservative) or surgical.

Conservative treatment is preferred, and includes rest, physiotherapy and the use of analgesics (even corticosteroid infiltrations).

In more severe cases, or if conservative treatment fails, surgery may be considered. It will be offered to patients with permanent pain, and/or a physical disability caused by the pain.

 

Celle-ci permet alors de diminuer le conflit et améliorer la mobilité de la hanche

 

Suite à cette intervention, un traitement kiné pourra alors démarrer.

 

 

8) WHAT IS PHYSIO REHABILITATION?

Conservative and post-intervention treatment are similar on many points. The difference will mainly be in the first weeks following the possible surgery.

While respecting the healing process, the work will focus on:

Recovery of normal joint amplitudes
Gradual rehabilitation of the joint
Recovery of a correct gait pattern
Overall muscle strengthening (strength, neuromuscular control, stability, etc.)
Re-athletics and getting back into sport (with correction of technique if necessary)

 

 

9) CAN I KEEP MOVING?

Unlike acute trauma, hip impingement does not require the cessation of activity. Depending on the symptomatology, it will also be necessary to adapt this activity.

The best option should be determined with your doctor and therapist.

 

We care, u perform.