Hip Cartilage Arthritis Linked to Failed Hip Impingement Surgery

This post is a bit of a mish mash on arthritis. Lots of new research has been published on femoroacetabular impingement, FAI, recently. PubMed is virtually exploding with new entries on hip impingement, FAI.  A few worth mentioning (and I might just come back with a more detailed version) touch upon the topic of why some surgeries to treat FAI fail. Failure isn’t a word patients like to hear, so here is what patients need to know.

Subspine (AIIS) Impingement - A 'New' Form of Impingement Next to the Hip Joint

By now femoroacetabular impingement (FAI), hip impingement, is well documented in the literature, although far from all orthopedic surgeons are qualified to diagnose and treat hip impingement. But a ‘new’ form of impingement, called subspine or AIIS (anterior inferior iliac spine) impingement is a diagnosis that is increasingly recognized.

Why is this important? Because in patients who have femoroacetabular impingement (high alpha angle and/or version), type II and type III shapes of the AIIS are associated with a decrease in hip flexion and internal rotation.

The Relationship between Hip, Sacroiliac and Low Back Pain – Preventing Unnecessary SI Fusions

Hip pain, sacroiliac (SI) joint and low back pain can be intrinsically related.  Previously, I had blogged about distinguishing hip pain from true sacroiliac pain. In light of an increasing number of people going under the knife to fuse their SI joints with the sacroiliac implant iFuse® (an estimated 5,000 people in the United States in 2013), I want to revisit the topic. I want to try to answer the question when SI fusions are warranted and what patients should know.

Iliopsoas Impingement as a Unique Cause of Hip Labral Tears

We know that bony lesions of the femoral head-neck junction (CAM impingement) and of the hip socket (pincer impingement) can cause labral tears. We also know that impingement of the iliopsoas tendon on the acetabular labrum is fairly common in patients with hip impingement (femoroacetabular impingement, FAI). Therefore a partial release, or tenotomy, of the psoas tendon is often performed during hip arthroscopy. Some physicians now say that, in some cases, psoas impingement in itself – without bony impingement – may be the cause of tears of the labrum.

Outcomes of Surgical Techniques for Hip Impingement, FAI, Surgery

New exciting research is available on surgical outcomes comparing several techniques. Hip impingement (femoroacetabular impingement, FAI) is characterized by bony deformities on the femoral head/neck and/or the acetabulum (hip socket). Some bony lesions may require open hip surgery with dislocation to address large, global lesions. Many CAM and/or pincer lesions can be addressed arthroscopically. But how much do the outcomes vary depending on the various techniques used by hip surgeons?

Physical Therapy / Rehabilitation after Hip Impingement (FAI) Surgery: The Benefit of Neurokinetic Therapy for Muscle Re-Education

A few weeks back, I mentioned I’d be back with a guest blogger, a physical therapist who uses Neurokinetic Therapy (NKT) in his practice. Here he is. Meet Kristopher Bosch, PT, DPT, ATC, FAAOMPT!

Most rehabilitation and wellness professionals eventually end up asking themselves: “Why do patients/clients come in with pain, go through a treatment session, leave pain-free or with significant improvement noted, and then return the next week with the same symptoms (often times over and over again)?”

Why You Need an FAI Surgeon Who’s Specialized in Hip Impingement: All Orthopedic Surgeons Are Not Equal

Recently, I met someone who had seen an orthopedic surgeon who told his patient that the labrum fills no function whatsoever. He would just cut it out, and the patient was told she would walk out of the operating room like it is nobody’s business. Doctors like this scare me because they clearly do not understand femoroacetabular impingement (FAI or hip impingement) but are happy to slice and dice their patients.

I say it in my book, but it is so important that I want to put it out here on the Internet for the world to read. Just because someone is a board certified orthopedic surgeon does not mean he/she is qualified to perform surgery to remove hip impingement and treat hip labral tears.