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:

Tuesday, 7 September 2010

Bad news from new consultant about retroverted acetabulum being significant.

Visited a new top hip consultant yesterday..
In short, after briefly looking at my x-rays and CT scan, he concluded that I do have retroversion and that it is significant.
That my hip sockets should be facing forward, anteverted, by 15 to 18 degrees, but instead are facing backwards, retroverted by 3 degrees. This is what causes the pincer impingement. A reverse acetabular periacetabular osteotomy (PAO) is the answer, except he feels that the results from such ops are entirely unpredictable, with success rates around 60 - 70% and that perhaps had I been 20, not now 40 then it 'might' have up'd my chances of success, however I am not!

Advice was to retry pilates and exercises to help adjust pelvic tilt to help minimize the retroversion and take pain killers.

One thing of note though was that that advice would've been the same a year ago, before FAI surgery.. however I do feel that surgery, whilst not 100% successful, was indeed worthwhile.

So personally I do feel that its not quite the end of the road.. not that I want surgery, I just feel I can arrive at a better place than I'm currently at.

On the upside, surprisingly I think that my right hip is actually improving still, even 14 months post op, which I did not expect at all! Yesterday I managed a 5 hr return trip to London, combined with several hours walking around the city and that after the previous day cleaning the house top to bottom... I thought I'd be on the floor by today, but surprisingly I have some achiness this morning and had a bit of groin pain and lateral hip pain walking about yesterday and today, so that's positive.

I still need to wait a couple of weeks for this consultant to have time to work out a number of angle measurements of my hips to confirm the facts.. so whilst feeling a bit hopeless during the appointment with the lack of a solution, I don't feel this is the end of the line. I suspect there is no point until the CT is analysed and I have accurate readings and therefore full facts.

I also think I just I have not yet encountered the right surgeon for me yet, its such a specialist area, with micro pockets of speciality even under the hip FAI umbrella.

I have not mentioned this consultant's name and will no longer do so in this blog.. as things didn't go brilliantly with Ernest Schilders and I found myself in a position where I had already named Professor Schilders in thanks for a diagnosis and along the blog, before I knew what the outcome would be. I do not want to compromise my honesty and so this is the obvious solution. How did Professor Schilders miss all this?