What is Femoroacebular Compression (Impengemet) Syndrome?
Femoroacetabular Compression, or sometimes simply diagnosed as Hip Compression, is a condition in which abnormal contact and friction of the ball and socket part of the hip bones damages the joint cartilage. In some people, it causes the hip joint to rapidly calcify and bone protrusions to form. In a hip that becomes unstable, bone protrusions develop, as the body tries to create a more balanced hip. Loss of balance in the hip can cause weakening of the ligaments and tendons of the hip, waist, groin and hamstring regions, and damage to the hip labrum (the rubber surrounding the edge of the acetabulum is a ring from fibrocardylation). In the following process, hip arthritis develops.
What are the Causes of Femoroacebular Compression (Impengement) Syndrome?
Femoroasetabular compression is a shape mismatch between the femur head and the acetabular nest. The hip joint is one of the body’s real ball-socket joints. Frictionless movement of the hip joint is possible if the hip ball (femur head) and the nest (acetabulum) fit perfectly. Any abnormality in any of these structures can interfere with the movement of the hip.
The three main causes of femoroacetabular compression are: PİnCER compression (excessive coating of the femur head of the acetabular nest), CAM bump (loss of roundness of the femur head) or these two conditions of the combined type occur together. In most cases, this disease occurs during the development of the hip. Although this disease is common in athletes, it also occurs in active individuals. Glass-type compression tends to affect male athletes most often in the teens (20s), while Pincer compression tends to occur more commonly in women in their 30s and 40s who are athletically active.
In addition, some diseases can lead to this disease;
- Legg-Calve-Perthes disease
- Femur Head Epiphyse Shift
- Koksa Vara
What are the Symptoms of Femoroasebular Compression (Impengement) Syndrome?
Pain (usually on the inner side of the hip or in the groin area), usually after walking or sitting for a long time (as in the car),
A feeling of locking, clicking or catching within the joint,
Hip pain after sitting for a long time (such as bus, air travel),
Difficulty wearing your socks and/or shoes,
Difficulty walking uphill,
Low back pain,
Pain in the back of the pelvis (sacroiliac joint), the outer part of the hip (large trocanter).
It is often confused with other sources of pain such as hip flexor tendinitis, hernia and testicular pain.
How is femoroacebular compression (Impengement) syndrome diagnosed?
Femoroasetabular Compression is not a stand-alone condition. It is usually part of a larger picture of hip imbalance.
Your doctor will ask about your hip (your symptoms and how your pain started, how long it lasted, etc.) and will perform an examination. It will move your hips and legs in different positions to assess your mobility and assess the positions where your hip hurts. An X-ray of your hip is likely to be requested to confirm the diagnosis.
X-rays: X-rays can show abnormal shapes of the hip bones. It also helps to detect the presence of arthritis.
Computed tomography (CT): CT scans help provide more information about the structure of your hips and pelvis. This examination is especially important when 3D CT scans are performed, which are good at giving the doctor a very realistic perspective on the shape of the bone.
Magnetic resonance imaging (MRI): This examination is a non-invasive, beam-emitting imaging technique that uses magnetic field and radio waves. MRI scans can detect damage to the cartilage or labrium of the hip. A paint (contrast agent) can be injected during scanning to make MRI scanning more precise.
Treatment Options for Femoroasebular Compression (Impengement) Syndrome?
Non-surgical methods are the first stage of treatment and may include changes in your activities. For those with symptoms, the first treatment includes rest and physical therapy methods. Your doctor may also recommend a drug injection to the hip or prescribe anti-inflammatory or painkillers.
Prolotherapy: Simple sugar is an injection of dextrose. The idea is that dextrose injections will lead to a controlled inflammatory response that will focus on strengthening and reconstructing the damaged soft tissue that keeps the hip in place. Strengthened soft tissue, that is, ligaments, will stabilize the hip joint and reduce destructive joint forces in the hip.
PRP (Platelet Rich Plasma Therapy): Re-gives your own concentrated blood platelets back to the hip area. Your blood platelets contain growth and healing factors. When concentrated through simple centrifuge, your blood plasma becomes “rich” in healing factors, so Platelet is called RICH plasma.
Femoroasetabular Long-term sequelae of compression have not been conclusively proven, but there is a lot of evidence that it may be an important cause of early hip arthritis.
Femoroasetabular Compression Syndrome surgery has not been proven to prevent calcification. However, removing the uncomfortable bone can help reduce further injury to the joint, while at the same time reducing symptoms. The results of surgery are clearly better when there is no joint cartilage damage. Surgical treatment can be performed using hip arthroscopy or open surgery.
In this treatment, an arthroscope (a pen-sized video camera) is used to see and treat the damage found using two to five incisions about 1 cm in size. Most often, all components of this disease can be treated with the help of an arthroscope, such as labral tear, damaged joint cartilage and bone changes between the ball and the nest.
Minimally Invasive Open Surgery:
In this approach, the hip is reached by making a small incision from the front of the hip. Various hip disorders are treated with the help of arthroscopic imaging. Similar to the arthroscopic approach, the results are similar since it is performed without displacing the hip joint.
The patient walks with crutches after surgery. Recovery time from most of these surgical procedures to full, unrestricted activity is 3-6 months. Your level of activity after surgery will depend on your surgeon’s recommendation, the type of surgery performed, and the condition of the hip joint at the time of surgery.