Pincer-Type Femoroacetabular Impingement (FAI)
Pincer-type femoroacetabular impingement (FAI) happens when extra bone grows over the rim of the hip socket, creating friction that wears down cartilage and compresses the labrum (cup-shaped piece of cartilage) over time. The thing to remember: Pincer FAI is a structural problem, not something that gets better on its own. The hip specialists at Summit Orthopedics diagnose and treat pincer FAI at locations across the Minneapolis/St. Paul area.
What Is Pincer-type Femoroacetabular Impingement?
If you have FAI, extra hip joint bone growth over the rim of the hip socket, causes your hips to have an irregular shape. These bones may rub together when you move, causing pain.
In pincer-type FAI, the problem is in the hip socket. Extra bone growth protrudes out over the normal rim of the acetabulum, and the cartilage between the bones, called the labrum, can be crushed under this prominent rim. Over time, this friction can wear down cartilage and damage the joint, potentially leading to hip arthritis.
Pincer-type FAI is one of three types of FAI. The other two include:
- Cam impingement: Extra bone grows on the femoral head, which grinds the cartilage inside the hip socket.
- Combined impingement: Both cam and pincer impingement occur simultaneously.
What Are the Symptoms of Pincer FAI?
Pincer-type FAI typically feels like a persistent dull ache that may spread to your buttocks, groin area or thighs. Some people describe it as a deep bruise.
Symptoms may include:
- Pain: A constant, dull ache in your groin or the outside of your hip that may feel like a sharp, pinching sensation when you move a certain way
- Stiffness: A tight feeling in your hip joint makes it harder to move your leg as freely as you used to
- Limping: Pain and stiffness affect how you walk
What Causes Pincer-type Femoroacetabular Impingement?
FAI usually happens because the hip bones do not form normally during childhood. Some people are born with unusually shaped joints, although bone spurs can develop throughout life.
Anyone can develop pincer FAI, but some factors make it more likely:
- Females are at a higher risk for developing pincer or combined impingement than cam impingement.
- Athletes are more likely than nonathletes to develop the pincer-type FAI, especially those who participate in sports that put heavy demand on the hips (note: exercise itself does not cause FAI).
How Is Pincer-type Femoroacetabular Impingement Diagnosed?
Your Summit Orthopedics specialist will review your symptoms and examine your hip to determine whether pincer FAI is the cause of your pain. The evaluation typically includes:
- Physical exam: Your provider will discuss your symptoms and medical history with you. They’ll likely perform an impingement test, which will involve moving your knee toward your chest, then moving it inward. If this recreates your hip pain, you likely have impingement.
- Diagnostic imaging: X-rays show whether your hip bones are abnormally shaped in a way that is consistent with FAI. CT scans give more detailed images of the hip’s shape. MRI scans help identify damage to the labrum and articular cartilage.
- Numbing injection: Your doctor may inject a numbing medicine into the hip joint. If your pain resolves after the injection, FAI is likely the problem.
How Do You Treat Pincer-type Femoroacetabular Impingement?
At Summit Orthopedics, our hip specialists always start with nonsurgical treatment for pincer FAI. Surgery is reserved for cases where conservative care hasn’t provided enough relief.
Nonsurgical Treatment for Pincer FAI
- Adjusting your routine: Making a few simple changes to how you move and avoiding the specific activities that spark your pain can ease discomfort and keep your joint protected.
- Medication and injections: Over-the-counter or prescription anti-inflammatories (such as ibuprofen) are great for controlling swelling and pain. If you need more focused relief, your provider might suggest a targeted cortisone injection directly into the hip joint.
- Physical therapy: Specific exercises can improve range of motion and strengthen supporting muscles, reducing stress on the labrum and cartilage.
What Not to Do With Pincer FAI
Try not to push through activities that trigger your hip pain. Continuing with high-impact movements without treating the underlying impingement can cause your cartilage to wear down faster and make your symptoms worse over time. Your care team will help you figure out which exercises are safe to keep doing and how to modify the ones causing trouble.
Surgery for Pincer FAI
If tests show joint damage caused by FAI and nonsurgical treatment hasn’t helped your pain, you may need surgery.
Doctors treat many FAI problems with arthroscopic surgery, performed using small incisions and thin instruments. During hip arthroscopy, your surgeon will fix or smooth out any damage to the cartilage and labrum. To correct the pinching, they will also carefully trim the excess bone along the rim of your hip socket. Some severe cases may require a larger open incision.
Care for Pincer-type Femoroacetabular Impingement at Summit Orthopedics
At Summit Orthopedics, our hip specialists take the time to understand what’s driving your pain and what you want to get back to—then build a plan around that.
Find your Summit Orthopedics hip expert, request an appointment or call us at (651) 968-5201 to schedule a consultation.
