Treatment for Hip Impingement

When a person is diagnosed with hip impingement, the doctor will recommend treatment options. These options typically include nonsurgical treatment, with an emphasis on physical therapy, and surgery.

Nonsurgical Treatments for Hip Impingement

People with hip impingement are advised to take a break from activities that aggravate symptoms. During this time, they can work with a physical therapist to strengthen the muscles around the hip and improve balance on the affected leg.¹Freke MD, Kemp J, Svege I, Risberg MA, Semciw A, Crossley KM. Physical impairments in symptomatic femoroacetabular impingement: a systematic review of the evidence. Br J Sports Med. 2016;50(19):1180. Physical therapy may help change the biomechanics of the hip and reduce symptoms.

See The P.R.I.C.E. Protocol Principles

Regenerative medicine options
If rest and physical therapy do not work, some physicians may recommend regenerative medicine treatments, such as platelet rich plasma (PRP), stem cell injections, or prolotherapy. The goal of these treatments is to improve the health of the joint’s soft tissue. Whether or not regenerative medicine treatments effectively reduce hip impingement pain is still being researched.

See Regenerative Medicine for Sports Injuries

Surgery for Hip Impingement

Surgery is commonly recommended to correct hip impingement. Exactly what type of procedure is performed will depend on what is causing the hip impingement and what type of soft tissue damage, if any, has occurred.

See Considering Surgery for Hip Pain

Below are some examples of surgical procedures done for hip impingement. More than one procedure may be done during a single surgery:

• Cutting and removing the bone tissue that contributes to the impingement, thereby expanding (decompressing) the space
• Labral debridement, which involves removing fraying edges and loose pieces of the labrum
• Labral repair, which can involve repairing labral tears by reattaching the labrum to the bone

See Recommended Treatments for a Hip Labral Tear

For most people, surgery will decrease hip pain and improve hip function. Surgery tends to be less successful when a patient:²Guyton JL, Hip Pain in the Young Adult and Hip Preservation Surgery. Canale ST, Beaty JH, Campbell's Operative Orthopaedics, vol 1, 12th ed., Philadelphia, PA: Elsevier/Mosby. 2013;333-373.

• Has signs of hip arthritis before surgery.
• Is older.
• Did not get pain relief from an a cortisone injection made directly into the hip joint capsule. (If done, cortisone injections are performed several weeks or months before surgery.)
• Has separation of articular cartilage from bone. This condition is called delamination, and it is difficult to detect before surgery.²Guyton JL, Hip Pain in the Young Adult and Hip Preservation Surgery. Canale ST, Beaty JH, Campbell's Operative Orthopaedics, vol 1, 12th ed., Philadelphia, PA: Elsevier/Mosby. 2013;333-373.

Hip surgeries are performed arthroscopically or with an open incision, depending on the procedure being performed; the patient’s anatomy; and surgeon’s preference.

See Different Types of Surgery for Hip Pain

Will surgery for hip impingement prevent future joint problems?
Most doctors believe that surgery to correct hip impingement will prevent or delay the development of hip osteoarthritis. Currently, there are no long-term studies that support or disprove this theory.²Guyton JL, Hip Pain in the Young Adult and Hip Preservation Surgery. Canale ST, Beaty JH, Campbell's Operative Orthopaedics, vol 1, 12th ed., Philadelphia, PA: Elsevier/Mosby. 2013;333-373.