Femoroacetabular Impingement (FAI) Treatment Options

Dr. Cinque, a leading San Diego sports medicine expert, often begins with nonsurgical treatments to manage FAI. These include:

• Physical Therapy (PT): Aimed at enhancing joint function and alleviating pain, PT focuses on exercises that strengthen surrounding muscles and improve range of motion. Custom therapy plans target the hip’s flexibility and stability.
• Activity Modification: Reducing activities that trigger hip pain, such as deep squats or twisting motions, can help minimize irritation and prevent worsening symptoms.
• Over-the-Counter Pain Relief: Nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce pain and inflammation.
• Rest and Icing: Short-term rest combined with periodic icing can alleviate swelling.
• Cortisone Injections: Administered directly into the joint, cortisone injections can provide temporary relief from pain and inflammation.

While these methods can be effective for reducing symptoms, conservative management does not correct the underlying bony impingement or labral tears. For individuals with persistent or severe pain, surgical intervention may be necessary.

Dr. Cinque’s goal in treating FAI is to preserve the natural hip joint, reduce pain, and improve long-term joint function. Surgical treatment is tailored to the patient’s unique condition and aims to address each contributing factor comprehensively.

FAI is a multifaceted condition that often involves:

1. Hip Deformities and Abnormal Bone Growth: These structural issues cause misalignment and impaired hip movement, leading to soft tissue pinching and labral tears.
2. Labral Damage: Tears to the labrum destabilize the hip joint, contributing to pain, restricted movement, and further cartilage damage.
3. Weakness and Instability: Muscle compensation and altered gait patterns can arise as the body tries to alleviate pain, exacerbating joint dysfunction and muscle fatigue.
4. Articular Cartilage Degeneration: Misaligned bones and joint instability can lead to the breakdown of the cartilage on the femoral head and acetabulum, resulting in osteoarthritis.

Surgical options for FAI range from minimally invasive procedures to more complex open surgeries. Dr. Cinque offers various surgical approaches to restore joint function and alleviate pain:

Hip Arthroscopy for FAI

Hip Arthroscopy for FAI Hip arthroscopy is a minimally invasive procedure that allows Dr. Cinque to access and treat the affected joint through small incisions. This technique is effective for addressing labral tears, ligament injuries, and articular cartilage damage. The benefits of arthroscopy include:

• Reduced recovery time
• Lower complication rates
• Minimal blood loss
• Less postoperative pain

A cortisone injection that provides pain relief can be a positive indicator for arthroscopic success. The procedure involves using general anesthesia and specialized instruments to:

• Reshape the femoral head and/or acetabulum (osteoplasty) to prevent further impingement.
• Repair or reconstruct the labrum to restore the joint’s seal and stability. Reconstruction may be necessary when the labrum is significantly damaged or detached from the bone.
• Address cartilage damage through techniques such as microfracture or autologous chondrocyte implantation.

Surgical Hip Dislocation for FAI

Surgical Hip Dislocation for FAI For cases where hip abnormalities are extensive, Dr. Cinque may recommend an open procedure known as surgical hip dislocation. This approach allows for a full view of the hip joint, enabling precise treatment of complex deformities while preserving muscle tissue and blood supply. Though more invasive, it is considered the gold standard for severe FAI cases.

Cartilage Restoration Procedures

Cartilage Restoration Procedures If cartilage damage is significant, various restoration techniques can be employed:

• Microfracture: This technique creates tiny fractures in the bone to stimulate cartilage growth.
• Osteochondral Allograft Transplantation (OATS): Replaces damaged cartilage with healthy cartilage from a donor.
• Autologous Chondrocyte Implantation: Cultivates and implants a patient’s own cartilage cells to repair defects.