Acetabular femoral impingement is a hip joint condition caused by abnormal joint structure or activity-related factors. It can be cam or pincer impingement, or a combination of both. Treatment options range from pain management to surgery, depending on the severity of the condition.
Acetabular femoral impingement is a condition affecting the hip joint, also known as the acetabulofemoral joint. A ball and socket joint, this joint is where the femur bone in the thigh, specifically its head or “ball,” meets a socket in the pelvis known as the acetabulum or “socket.” Impingement of this joint occurs when there is excessive friction between the femoral head and the acetabular socket, due to a dysfunction in the shape of the femoral head or in the surface of the acetabulum that would limit motion in the joint. It is caused by abnormal joint structure, activity-related factors, or a combination of both.
This condition falls into one of two categories, cam and caliper impingement, although it can occur as a combination of both. Acetabular femoral cam impingement refers to an abnormality in the shape of the femoral head, which ideally should be spherical. This abnormality can lead to a scrape of the femoral bone against the socket, which can damage the cartilage within the joint that acts as a cushion between the two bones.
Pincer acetabular impingement occurs when the acetabulum covers the femoral head. This is typically seen along the rim of the acetabulum at its superior surface, where it meets the top of the ball of the femur. Often the rim protrudes too much outward above the ball, causing the labial cartilage to degrade as it becomes trapped in the space between the two bones. The labral cartilage surrounds the rim of the acetabulum, creating a cushion between the socket and the femoral head and helping to hold the head in place in the joint.
In many cases, both cam and pincer acetabular femoral impingement are present: the abnormal femoral head rubs excessively into the socket, and the acetabulum covers too much surface area of the femur. The likelihood of this condition is increased in active individuals, more so in those who participate in certain sports such as gymnastics. Treatment for acetabular femoral impingement depends on the severity of the condition and can range from pain and lifestyle management to surgery. Conservative treatment options may include physical therapy and over-the-counter or prescription pain relievers, while surgical options include arthroscopic and traditional surgery, depending on whether the femoral head, acetabulum, or joint angle requires modification. Whatever treatment is recommended, the goal is generally to delay or prevent a hip replacement later.
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