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Treatments for Hip Impingement

FAI syndrome can be actively treated with either physiotherpay or surgery; which can be arthroscopic (keyhole) or open. The FASHIoN trial is comparing arthroscopic surgery and physiotherapy (Personalised Hip Therapy).

Personalised Hip Therapy (PHT)

Hip impingement can be treated with a special course of physiotherapy designed to help your hip called Personalised Hip Therapy (PHT).

PHT aims to improve hip muscle control and strength and correct abnormal movement patterns. By improving hip control patients can prevent the premature contact that occurs in FAI syndrome, improving symptoms, allowing a return to activities and preventing reoccurance.

PHT was developed using published evidence and building a consensus amoung physiotherapists who treat patients with FAI syndrome. Through consensus building we were able to develop the PHT treatment protocol. The protocol has now been published- see publications. You can view a video of how and why PHT was developed here.

Features Benefits Risks
  • Individualised exercise based program
  • Delivered and supervised by senior muscle skeletal physiotherapists
  • Patients would see their physiotherapist 6-10 times over a 3-6 month period
  • Involves a detailed assessment of your hip
  • Includes help with pain relief
  • Provides advice about FAI
  • Incldues an exercise based program that is progressive through time (allowing a return to sports)
  • Correct abnormal movement patterns
  • Retrain and strengthen the muscles around the hip
  • Improvement of symptoms between 4 and 6 months
  • Specialised healthcare team who have deep understanding of the hip joint and FAI
  • Pain may increase at the beginning of treatment
  • Pain may return if patient looses the control re-established during PHT

Hip arthroscopy

Arthroscopic surgery for FAI syndrome aims to reshape the hip by removing bone from the acetabular (socket) rim and or the femoral neck (ball). These techniques are technically challenging due to the depth and the complexity of the hip joint. Surgery for FAI syndrome has been undertaken since the condition was first described in 2003. However initially all surgery was performed by a large open procedure. Over the course of the last decade more surgeons have become familiar with performing the procedure arthoscopically (keyhole).

Features Benefits Risks
  • Performed by consultant surgeon
  • Under a general anaesthetic.
  • 2-4 small cuts made on the outside of the hip
  • A small telescope Instruments are passed into the joint
  • A day case or an overnight stay in hospital
  • Patients typically spend 2 weeks on crutches although in some cases surgeons will require an more extended period of 6-8weeks non weight bearing
  • After surgery patients will typically be given some exercises by a physiotherapist
  • Alter hip shapes to prevent premature contact
  • Stimulate repair of damaged tissue
  • Improvement of symptoms between 4 and 6 months
  • Return to work is dependent on job; an office worker may be able to return 2 weeks after surgery, it may take manual workers several months to return to work
  • Temporary numbness in leg
  • Infection
  • Deep vein thrombosis
  • Fracture or damage to the blood supply of the femoral head; very rare complications
  • Ongoing pain


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