The hip forms a ball and socket joint. The ball-shaped surface of the femur (thigh bone) fits and glides smoothly in a cup-like depression or socket of the acetabulum (hip bone). This smooth motion can be affected by an abnormally-shaped femoral bone or socket rim, leading to a condition called femoro acetabular impingement (FAI), which limits hip movement. The defective fit causes the bones to rub against each other and damage the cartilage (cushioning smooth tissue on end of bones) that lines the femoral head and acetabulum, and the labrum (fibro-cartilaginous rim around the acetabulum).
Femoro acetabular impingement can be treated with osteoplasty and rim trimming. Osteoplasty is a surgical procedure performed to treat bony outgrowths (bone spurs) extending from the acetabular rim (pincer). Rim trimming (acetabular rim trimming) is a procedure used to correct the irregular surface around the edge of the femoral head.
Osteoplasty and acetabular rim trimming can be performed as an open surgery or as a minimally invasive procedure using an arthroscope (a thin tube attached to a lighted camera). A single large incision (open surgery) or 2-3 smaller cuts are made to access the femoral head (arthroscopy). Osteoplasty involves the use of a motorized burr to trim the excess bone at the femur neck. Acetabular rim trimming involves the use of a motorized burr to trim the acetabular rim. The amount of bone removed during this procedure depends on the presence and type of impingement.
In case of labral tears the surgeon uses anchors and sutures to stitch the torn labrum to the acetabular rim. Your surgeon will also repair any cartilage damage present. Once the cam and pincers are trimmed and damage to the labrum and cartilage are repaired, your surgeon will close the incisions.
Following the surgery, you will be kept under observation. You may experience numbness or tingling sensation for many hours due to anesthesia. You will be given pain medication to relieve pain and make you feel comfortable, and anti-coagulation therapy to prevent clots in the veins after the surgery. On the day after surgery, you will start physical therapy to teach you exercises to strengthen the muscles and improve range of motion
Risks and complications
As with any surgical procedure, hip osteoplasty and rim trimming surgeries may involve the following potential risks and complications:
- Nerve injury
- Deep vein thrombosis (blood clots in the veins)