MRT of the hip
While the CT examination provides a good overview of the changes in bone structure caused by hip impingement, the relevance of an MRI examination lies in the depiction of the cartilage structure at the hip. MRI can be used to visualize the abrasion and degenerative changes in the cartilage of the joint surface and the cartilage lip at the edge of the acetabulum (labrum). This is important for planning further treatment and provides information on how much damage has been caused by impingement.
TreatmentOperation
Hip impingement can be treated conservatively and surgically. If the symptoms are not yet far advanced, an attempt can be made to avoid surgery in order to achieve therapeutic success. However, conservative treatment options can only be used to treat the symptoms of hip impingement.
The basic problem, the deformity of the femoral head and socket, is not solved by this. Conservative treatment methods include drug therapy with NSAIDs (non-steroidal anti-inflammatory drugs) such as aspirin, diclofenac or ibuprofen. These substances have an anti-inflammatory and analgesic effect and thus improve the symptoms of hip impingement patients.
Furthermore, intra-articular injections (into the joint) can be applied, which place the active substance directly at the affected area. Physiotherapy can strengthen the muscles and thus improve mobility. Since hip impingement often occurs in connection with certain sports, it is advisable to take a break from these sports in order to avoid the pain-causing movements.
In any case, a sports leave should be discussed in detail with the treating physician. Since all conservative treatment methods cannot eliminate the cause of hip impingement, long-term therapeutic success is not guaranteed. If conservative treatment fails, surgical therapy is indicated.
The aim of the operation is, on the one hand, to treat acute pain by eliminating the cause of the pain and, on the other hand, to remedy the damage that has already occurred. Hip arthroscopy represents a low-risk alternative. Hip arthroscopy (hip joint endoscopy) is a minimally invasive procedure for the diagnosis and therapy of hip joint changes.
An endoscope and the necessary surgical tools are inserted into the joint through small incisions (incisions). Especially in the case of CAM impingement, hip arthroscopy is an alternative to larger open procedures. A camera at the end of the inserted probe makes damage such as a tear on the acetabular lip visible to the surgeon on a monitor.
The surgeon can then use this minimally invasive procedure to stabilize the lip again. In addition, cartilage growths or small deformations of the bone in the pelvis or thigh can be removed. Special tools for this technique make it possible to restore the neck of the femur to its original waisted shape, thus restoring pain-free joint function.
With pincer impingement, hip arthroscopy is somewhat more complicated to perform, but it is certainly possible. The aim here is to move the edge of the socket further inwards. The original joint lip is now replaced by a bone ring, which is removed by the surgeon.
An older procedure is the surgical hip dislocation within the framework of an open operation. For this, the hip joint is opened in order to dislocate (luxate) the hip ball from the socket. The hip luxation offers an optimal view of both parts of the joint in order to visualize and repair the damage.
Today’s surgical procedures offer an effective therapy to relieve acute pain and restrictions. While hip arthroscopy as a minimally invasive procedure is associated with faster recovery and mobilization of the patient and less pain, open hip luxation is technically less demanding and time-consuming and in some cases unavoidable due to the special anatomical conditions of the hip. and pain after hip surgery