Article reviewed and approved by Dr. Ibtissama Boukas, physician specializing in family medicine
The pathologies full hip concern several individuals, in particular athletes. Sometimes, they can become a real constraint, even a handicap, especially in the absence of treatment. They also affect the physical performance of the affected person. the conflictfemoro-acetabular is one of the pathologies affecting the hip. It concerns approximately 3 to 15% of the population. But what is it really about? You will learn more in this article.
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Definition
Le femoroacetabular impingement (CFA) is defined as the incongruencebetween the edge of the femur and the acetabulum (also called acetabulum). From an anatomical point of view, the latter corresponds to the articular cavity of the pelvis in which the head of the femur is housed.
This incongruence corresponds to contactabnormalprecociousbetween the head of the femur and the acetabulum, in various anatomical situations, determining the different forms and types for this pathology.
Primary femoroacetabular impingement
Le CFAprimary is linked to alterations ou anomaliesmorphological du femur or the acetabulum, sometimes both. Depending on the structure affected by the anomaly, different forms of primary CFA can be determined.
Primary CFA of the formPINCH or effect " pliers " : when the anomaly concerned the acetabulum. This is the case when the acetabulum is too deep or too prominent, thus covering a very large part of the femur. This causes pinching at the femoral neck.
Primary CFA of the formCAM ou CAME: when the anomaly relates to the head of femur, its neck, even the neck-head junction. In this case, these parts may have bumps that result in excess bone. Thus, the contact between these surfaces becomes abnormal.
Primary CFA of the formMIXED: Yes the acetabulumetlefemur are both subjects anomalies.
Secondary femoroacetabular impingement
Le CFAsecondary, meanwhile, corresponds to anomalies anatomy of the femur and acetabulum following sequelae related to other hip pathologies.
The causes of femoroacetabular impingement
The causes du femoroacetabular impingement are many.
The pelvic structural abnormalities and femur who can be congenital ou acquired. Factors environmental et genetic may be the origin.
The antecedents de certain pathologies, for the case of CFA secondary, like the Perthes disease, de epiphysiolysis of the femoral head.
The trauma or broken bones in the hip structures.
A strong load on the hip, a repetitive microtrauma between the femur and the acetabulum by frequent movements of flexion, adduction or abduction, rotation with support.
In the majority of cases, this pathology is favored by the practice of sports such as: football, baseball, basketball, rugby, golf, classical dance, swimming, running, martial arts...
This is also why the CFA displays a prevalencevery important for jeunes who exercise a strenuous physical activity. Their bones are not yet mature, which puts them at greater risk of injury during training. However, sportsmen and athletes, whatever their age, are all people at risk.
What are the symptoms of this hip joint disorder?
Le typical symptom offemoroacetabular impingement is the painaulevel of fold ofoldest boy. It also attacks the front or rear or side of the hip and can spread to the buttocks, thighs or knees.
The pain felt can be deep or throbbing. And it appears suddenly or gradually following certain physical activities or certain positions (prolonged sitting, for example).
With femoroacetabular impingement, the patient suffers from sensations of blocking ou hooking in the hip.
The symptoms of this joint disorder lead to limitation of mobility. Le CFA can cause injury to the labrum and damage to the joint stability of the hip, which is partly ensured by this fibro-cartilaginous structure. At worst, this conflict could evolve into a hip osteoarthritis. This is a very frequent case.
How to make the diagnosis of CFA?
In the presence of any of these symptoms, it is always a good idea to consult a orthopedist for a diagnosis.
Le CFA diagnosis consists of the study of the history and a clinical examination.
For the clinical examination, the doctor first assesses the physical condition of the patient, his posture when standing and his condition when walking to detect any abnormalities such as the presence of the Trendelenburg sign which reflects abductor insufficiency.
Then he practices examsneurological et vascular of ,lower. The palpation and the achievement of some maneuvers can provide more explanations and details regarding the symptoms experienced by the patient.
The most effective maneuvers to assess the presence of the femoroacetabular impingement are :
la maneuver de FADIR : flexion-adduction-rotation test internal the patient's thigh or hip in the supine position. the CFA is positive if this test generates any pain at the level of the groin;
the maneuver of FABER : flexion-adduction-rotation test external thigh or hip in the supine position. He is positive if during its realization, the patient feels a pain.
Personalized imaging exams may also sometimes be necessary for the diagnosis of CFA. They provide more details on the pathology and the injured structure. The most common exams are:
la radiography du basin : to detect the anomalies mentioned above;
thearthro-IRM full hip: to assess the condition of its structures;
the scanner, CT scan : for more details on the state of the conflict et consider treatment adequate to adapt. They also help guide surgery, for example.
How to treat this joint disease?
Treat CFA consists in relieving the symptoms and above all in restoring normal contact between the head, the neck of the femur and the edge of the acetabulum.
Symptomatic treatment
To treat the symptoms, doctors prescribe anti-inflammatories and painkillers. It is also possible to opt for natural products to relieve pain: garlic, ginger, turmeric, certain essential oils such as wintergreen.
Basic treatment of the disease
Conservative treatment
It boils down to a modification of activities of the patient, starting with a repos associated with the avoidance of certain movements or certain positions likely to aggravate the situation.
Then comes the remobilization and the enhancement muscle by activities specific or by physiotherapy. All this, with the aim of restoring the abnormalities and protecting the structures of the hip. To be effective, conservative treatments must always be closely followed, while frequently evaluating the evolution of the pathology. In case the symptoms persist, it would be better to move towards surgical treatment.
Surgical treatment
Le CFA treatment can be done by a surgeryarthroscopic or an surgeryloan. The choice depends on the patient's condition and the severity of the disease. Thus, conventional surgery is only performed in the event of major deformities.
The principle of the surgery is generally to improve the range of motion by removing the protruding parts that make the femoro-acetabular contact problematic. Although effective, surgical treatment always presents risks.
Furthermore, one should not neglect the re-education. It greatly contributes to the success of the gradual resumption of the patient's activities.
In conclusion, the conflict femoroacetabular influences physical performance as well as daily life. However, it is quite possible to treat it in order to regain the normal functions of the joint. femoroacetabular.
My name is Arotoky and I am studying human medicine. Web editor for more than 5 years, I currently focus on the theme of health and well-being. I have the strong conviction that with my valuable articles, I can help many people to relieve their ailments and feel better. My goal is to share my health knowledge with the general public through web writing.
