I've pretty much decided to agree to surgery for our 16-year-old son who has a hip impingement problem. We are convinced that this will help prevent arthritis later in life. What are the most likely complications from a surgery of this type?
FAI occurs in the hip joint. Hip pain, abnormal joint mechanics, and loss of hip function describe the three most difficult problems with femoroacetabular impingement (FAI). Impingement refers to some portion of the soft tissue around the hip socket getting pinched or compressed.
Femoroacetabular tells us the impingement is occurring where the femur (thigh bone) meets the acetabulum (hip socket). There are several different types of impingement. They differ slightly depending on what gets pinched and where the impingement occurs.
Current understanding of this hip deformity has resulted in surgery to correct the deformity. The short-term goals are to relieve pain and improve function. As you have found out, the long-term goal is to prevent hip osteoarthritis.
Any surgery for any problem comes with the possibility of complications or problems. Surgery to repair a femoroacetabular impingement is no different. Some complications occur during the operation itself (e.g., bone fracture, reaction to the anesthesia).
Others develop later during the postoperative period (e.g., infection, continued pain, blood clot formation). It's even possible to develop long-term complications. The bone may fail to heal, blood supply may become compromised, or hardware may break or back out of the bone.
The whole procedure may fail to reduce pain and improve function. That means with repetitive load and use of the joint, cartilage destruction and joint degeneration may lead to osteoarthritis -- the very thing you are trying to avoid.
It is good to be prepared for anything that might happen but expect good results. Ask your surgeon what he or she usually sees (if anything) with the particular surgery your son will have. Most complications are minor and easily corrected.
John C. Clohisy, MD, et al. Surgical Treatment of Femoroacetabular Impingement. In Clinical Orthopaedics and Related Research. February 2010. Vol. 468. Pp. 555-564.
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