Labral tear

Most patients have mixed forms of cam and pincer impingement Here, degenerative changes are seen in both the socket and on the femoral neck. In all impingement cases, in parallel with these changes, labral tears of variable severity occur.

With the impingement mechanisms presented in mind, you might hypothesize that the labral tear could have occurred first, and depending on joint load over time, then the osseous bumps mainly on the acetabulum and femoral neck would develop. Actually, this concept is supported by the fact that many of our patients report that they have had occasional stabbing pain in the groin region for many years. Taken together, the impingement was most probably caused by a labral tear. Unfortunately, we see that misdiagnosis is common and can delyay appropriate treatment for several years.

An early and exact diagnosis by an experienced specialist, who has years of experience, especially in hip arthroscopy, is a must.

Today, an impingement can be eliminated arthroscopically. Depending on the situation, the joint socket, the neck of the femur, or as in most cases, both are corrected. If the labrum is only ruptured and not grossly damaged, it can additionally be reattached by experienced specialists during a single surgery.

Open surgery is thus no longer needed because the same operation can be performed with a minimally invasive technique. Although it has clear benefits, this kind of surgery is not performed everywhere because it requires a specially trained surgeon. Since 1998, we have performed hip arthroscopy on more than 3000 patients. As a result, we are one of the largest and most experienced centers worldwide.

If someone recommends open surgery to you for a hip impingement, claiming “otherwise it couldn’t be done right,” you need to be cautious. Ask first how many hip arthroscopies the physician in question has performed. If he or she is evasive or states a relatively small number of surgeries performed, you would be best advised to look for a different surgeon.

If the surgery is performed correctly at the right time, full physical exercise is typically possible again (see patient testimonials). What must be taken into account with these forms of impingement is, however, an increased risk of acquiring arthritis.