Early hip diagnosis may help some athletes avoid surgery

Not long ago, femoroacetabular impingement (FAI) or hip impingement could sideline an athlete for good. Not so today, according to a recent study in the American Journal of Sports Medicine.

An estimated 95 percent of professional athletes return to their sport after surgery to correct FAI. Tennis player Tommy Haas and baseball’s Alex Rodriguez are among them.

Their stories are especially encouraging for young athletes diagnosed with FAI. With better diagnosis and treatment, they may stay active in sports much longer than their predecessors.

For the most part, FAI is a mechanical problem caused by excess bone on the ball of the hip or the hip socket. Either way, the surrounding cartilage (labrum) may be damaged over time, according to G. Peter Maiers, MD, an orthopedic and sports medicine physician at Methodist Sports Medicine.

“Think of it like shoving a square peg into a round hole,” Maiers says. “Either the socket is abnormal and captures the ball, putting the labrum at risk for damage, or the ball is abnormally shaped and begins to damage the cartilage as it forces its way into the socket.”

Historically, FAI was often missed because its symptoms resemble other injuries, including a pulled groin muscle or strained hip flexor. The downside of a late diagnosis is that it sometimes prevents patients from taking advantage of more conservative treatments.

“We try to manage conservatively with activity modification, exercise modification and physical therapy,” he says. Patients who do best with that strategy are usually diagnosed before abnormal forces on the hip joint cause significant damage to the surrounding labrum. 

In our next post, learn how doctors diagnose hip impingement, and how quickly minimally-invasive arthroscopy surgery can get athletes back to their sport.