Hip Impingement Treatment Without Surgery

Femoroacetabular impingement (FAI) occurs when abnormal contact between the ball and socket of the hip joint causes pinching of the labrum and cartilage with hip movement. It is a common source of groin pain in active adults and athletes, and if left untreated, can accelerate hip joint degeneration.

At Palm Beach Regenerative, Dr. Ghattas provides honest assessment of FAI, clearly distinguishing the structural component that drives impingement from the inflammatory component that can be addressed with orthobiologic treatment. Give us a call to schedule an appointment today.

FAI occurs in two patterns: cam impingement, where the femoral head has an aspherical bony prominence, and pincer impingement, where the acetabulum overcoverage pinches the femoral head. Mixed patterns are common. During hip flexion or rotation, this abnormal morphology creates repetitive impact on the labrum and cartilage.

• Groin pain with hip flexion, including sitting, squatting, or getting out of a car
• The classic ‘C sign’: the patient cups the hand around the hip when indicating pain
• Pain with athletic activities requiring hip rotation
• Limited hip internal rotation
• Clicking or catching in the hip
• Low back pain from compensatory movement patterns

• Bony morphological variation of the femoral head or acetabulum, often developmental
• More common in athletic individuals with high hip loading
• Associated with hip dysplasia in some cases

X-ray identifies the FAI bony morphology. MRI with arthrogram is the most sensitive study for assessing labral and cartilage damage associated with impingement.

Dr. Ghattas reviews your imaging to assess the degree of structural impingement, labral damage, and cartilage involvement before discussing treatment options honestly.

• Physical therapy for hip mobility and movement pattern correction
• Activity modification to avoid impingement positions
• Hip arthroscopy to reshape the bone (osteoplasty) and repair the labrum: The definitive treatment for structural FAI with significant labral damage

Orthobiologic treatment for FAI focuses on managing the inflammatory component within the hip joint and supporting the labral and cartilage tissues that have been damaged by repetitive impingement. This approach does not correct the underlying bony morphology.

For patients with mild structural impingement and early labral changes who wish to avoid or delay surgery, image-guided hip joint injection may provide meaningful symptomatic relief. For patients with significant structural impingement and complete labral tears, hip arthroscopy is the appropriate intervention and Dr. Ghattas will say so directly.