Dr. Josué Calderón Gamba

Hip impingement

The term hip impingement is actually very broad and covers anatomical alterations or abnormalities in which the Head and Neck of the Femur or the Acetabulum have a bone deformity that conditions an abnormal friction between them, which leads in certain ranges of mobility to damage to the Acetabular Ring and Acetabular Labrum complex.

There are three main causes:

Acetabular PINCER retroversion: The acétabulum does not develop normally during the growth of the child, presenting a direction towards the posterior contrary to the normal which is towards the front. In this case, it excessively covers the Head of the Femur and does not allow adequate mobility, as well as abnormal contact.


CAM or Cam type lesions: These lesions appear where the Head meets the Neck of the Femur, they usually develop during adolescence manifesting as a prominent deformity of this union, causing the head to not fit correctly within the Acetabulum, and increasing the stress from contact with the upper part of the Acetabulum and the Acetabular Labrum.

Femoral retro-torsion: It happens when there is an abnormal position of the neck of the femur, moving posteriorly in a horizontal plane, which can also cause a hip impingement.

Symptoms:

When there is a Hip Impingement, the patient feels groin pain, which increases with activities that involve flexing the hip such as running, jumping or sitting for a long time. There is also a loss of internal rotation of the hip and finally a labral tear occurs during evolution, increasing pain in that area. Over time, the Threading damages the articular cartilage and the acetabular labrum, producing osteoarthritis, causing pain, stiffness and loss of flexibility. It is common in activities that involve extreme ranges of hip mobility such as some types of dance.

Handling:

Clamps are not the same in all patients, on the contrary, each one is different, so there is no single treatment plan since the symptoms, activity level, anatomy, general body mechanics and amplitude must be evaluated. movement, and also the damage that has occurred in the Labrum and Cartilage.

When it is a mild or moderate case, it is possible to suggest a more conservative treatment that involves a change in physical activities, analgesics, physical therapy and in some cases, infiltration with corticosteroids. In more serious cases, a good option is Arthroscopy to correct the deformity, repair the labral and manage the damage to the articular cartilage. After surgery it is important to carry out physical rehabilitation work, if it is done correctly in 6 months the patient can return to physical activities.

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