FAI Hip Impingement (Femoro-acetabular Impingement)

FAI Hip Impingement Awareness facts - It is estimated that approximately 15% of the young, adult population have hip impingement, so who do you know that might have it?
Hip impingement causes painful labral tears within the hip socket.
Hip FAI symptoms are misleading to the average medical professional, as FAI hip impingement pain frequently presents as low back pain and interesting only 10% of back pain is ever clinically diagnosed and cured... Which begs the question what percentage is actually caused by hip FAI or hip impingement, as its otherwise known.
The more active you are, the more likely you are to trigger hip impingement symptoms, so busy mums and gym bunnies beware... but at least you're in good company as many premiere league football players have also suffered FAI hip pain.
Hip impingement is diagnosed through x-ray and labral tears are diagnosed through MRI arthograms - but both need to be read by hip consultants specifically trained in FAI hip impingement.
There are 60,000 hip replacements every year in the UK and it now appears that FAI hip impingement, over the years, could be the leading cause of hip osteoarthritis. A silent epidemic.
Hip arthroscopy can reduce the hip impingement and reattach the torn labrum to the hip socket. This surgery can eliminate the pain and disability caused by FAI hip impingement and divert the need for hip replacement in later life.

Also please feel welcome to join in our help and advice forum for support. We have 3 advising FAI expert hip surgeons, 3 PT/physios and a sports medicine doctor as well as the largest international FAI hip impingement forum on the net:

Saturday, 27 June 2009

Hip arthroscopy - what is it?

What is a hip arthroscopy? ...Well hopefully I'll be nicely under so as not to recall, but my understanding is: they lay you on your back and put a padded post between your legs, pull the offending side leg down by 1 cm or so, to dislocate the joint, then they make 4 x 2cm incisions within which they insert a camera to view the miserable, grumpy hip thats been ruining your life for however long and give it a good talking to! ..no sorry, they view the damage and do their best to cut away the ruined parts of the labrum and re-anchor it back to the acetabulum. If though the labrum is so shredded through injury, be it traumatic or repetitive, there is no alternative but to remove it. They call that debrideing.
If you also have FAI pincer type they then get out the black and decker and 'TRIM' (what a illusionary nice word,) away acetabular rim until it recedes enough, that on re-test bone no longer hits bone and the impingement is gone. Or if you have the cam version or bony abnormalities they shave those down, so as to no longer impinge. Stitch you back up and bob's yer uncle! IF ONLY!

Here's how I imagine mine will go, with the scary bits they don't tell you! What is it like to have a hip arthroscopy??? So few people know..
From my point of view, as I steer towards 10th July 2009, I veer all over the place trying to google answers...hence why I am writing this, as no doubt there will be someone a few steps behind me.. you poor thing you!

I know this much, its the stuff that will happen whilst I am still awake that will get me! I will turn up shakily to hospital on the 10th July and beg for a pre-med (else risk bolting out!)

I believe I will then be led to theatre, terrified and intimidated by all the shiny technology and sterile green surgical uniforms. I will feel vulnerable wearing bugger all below my ridiculous bum flashing gown. I will be positioned on the bed, possibly with a hideous post between my legs, which they will later use to dislocate my hip (ok I shouldn't be thinking in this much detail I'm starting to breath too fast again, pass me a paper bag someone!) Then they will hack away for a good 5 mins as they try to get a needle into my hand or arm. I only have one available vein for that, which they never believe and insist of trying more convenient veins. They will persist and roll their eyes at each other before then relenting and using the advised vein in my right arm.

Then I know I will panic and say to my surgeon "Seriously please try keep the labrum, don't remove it, cos I've read the recovery isn't nearly as successful if debrided." Followed by a few more pleas to make me better after 6 years of suffering! Then I'll plead with the anesthetist to pay attention to keeping me alive and reel off that I might have a heart attack, or forget to breath and finally I'll say please make sure I'm ok, cos I really love been a mummy or some ridiculous statement, hopefully followed swiftly by 10, 9 zzzzzzzzzzzzzzzzz
And I prey when I wake (or that I do wake!) that I am not in too much pain, or too freaked out.

I came round from a sedation a few months ago, after a steroid procedure, well I didn't come round exactly, because they couldn't knock me out, as I was so wired! But as I 'came round' I could hear people groaning and really distressed in the recovery room, coming round from anesthetics... scary stuff..
I asked the nurse tending me for any tips re anesthetics and he said 'REALLY TRY to fall asleep with nice thoughts and feelings as you tend to wake in the same way you go to sleep'. I thought great! I'll probably wake screaming, sit bolt upright and try make a dash for it ending up flat on my face forgetting I can't walk after surgery!

hmmm normally I feel better after writing this, like I've off-loaded, but this time I feel all wound up!

BUT the other thing is in the states, you know where its 'really' 2009 as opposed to the UK where technology filters so slow its more 1989, the have ALL SORTS for rehab. They have pressure inflating leg wraps to avoid DVT, here its "can you just wiggle your toes regularly please".
They have you on CPM machine 6 hrs a day or so for passive motion, to keep the joint moving and boots to wear in bed to force your legs straight....here, NOTHING ...and that worries me!
I asked what was my aftercare and was told I'd be given a folder of exercises to keep me REALLY busy and see a physio intensively, twice a week? I call that casual!
SO, the aftercare looks a bit patchy here in jolly old bloody blighty!

Let me tell you this, I don't yet know how bad or good the surgery is, nor the long, long, long rehab, but I can tell you the actual waiting for the op is utter torture. If you're 'slightly' scared of hospitals and all they mean, like me its got to be the worst part, hasn't it??!


  1. Hey, don't forget the sexy paper knickers you get to wear down to theatre-and if you're lucky they might even come back with you-albeit ripped down the sides!!lol
    Also from day one post-op Schilders will have you pedalling away on an exercise bike( no resisitance!)
    Don't compare too much with the US-don't forget they get charged for everything they use, things are more money orientated out there, you will get everything you need.

  2. oooh thank you Kate! That never occured to me! I've turned into a nutcase today, I think its the ankle biters making so much noise I can't hear my own thoughts and it stresses me out even more. So glad you said we get knickers, I'm really worrying about the silliest things, like modesty!

  3. Wow, reading this part now, 11 days post op, you sure have done your research! I was not aware of some of the pre-op info, I did a little research before hand, but I think too much would of left me very, very scared to have the surgery.