Femoroacetabular impingement, or FAI, is a hip condition where the ball and the socket are shaped so that they pinch against each other instead of freely gliding. That pinching can cause range of motion loss and can tear the labrum over time and wear the cartilage. Dr. Presley Swann treats FAI arthroscopically in Denver, reshaping the bone and repairing what the impingement damaged.
The Problem
It usually starts as a pinch in the front of the hip or the groin. Sitting for a long time bothers it. So does getting in and out of a car, squatting, or the deep part of a stride. Some people feel a catch or a click. Many are told it is a hip flexor strain, treat it as one for months, and get nowhere.
The reason it does not resolve is that nothing was strained. The bones themselves are shaped so that they run into each other at the end of the motion. Rest calms it down and the motion brings it back, because the shape has not changed.
How Dr. Swann Approaches It
FAI comes in two specific shapes, and most hips that need surgery have some of both.
Cam. The femoral head is not perfectly round where it meets the neck. That extra bone jams into the socket when the hip bends, and it shears the cartilage on the way in.
Pincer. The socket covers too much of the ball at its rim. The neck of the femur bumps into that rim, and the labrum, the seal around the edge of the socket, is crushed between the two.
Dr. Swann treats both arthroscopically, through small incisions with a camera inside the joint. Which parts are done depends on what the hip needs:
- Femoroplasty, reshaping the femur at the head and neck junction to relieve a cam.
- Acetabuloplasty, reshaping the socket rim to relieve a pincer.
- Labral repair or debridement, depending on the condition of the labrum.
- Psoas release, softening a tight band of the psoas tendon when that is part of the problem.
- Capsular repair and closure, so the joint is left stable.
Surgery takes about one to one and a half hours, and it is a same day procedure. Most patients go home the day of surgery.
Diagnosis comes before any of that: a history and exam consistent with impingement, X-rays in specific views, and both MRI and CT imaging to see the shape of the bone and the state of the labrum.
Why Patients Trust This Practice
- Fellowship trained in hip preservation, in a field where arthroscopic FAI treatment is a subspecialty rather than general orthopedics.
- A nationally known teaching surgeon in the hip preservation world, and the founder of the Hip and Knee Fellowship.
- Between 20 and 30 percent of the practice travels from out of state.
- Serving the Denver metro area from our Englewood office, 799 E Hampden Ave Ste 400, Englewood, CO 80113.
Frequently Asked Questions
What is the difference between cam and pincer impingement?
Cam is extra bone on the femoral head where it meets the neck, so the ball is not perfectly round and jams into the socket. Pincer is a socket that covers too much of the ball, so the rim gets hit. Many hips have both. Imaging is what tells them apart.
How long am I on crutches?
Two to four weeks for most procedures. You start with two crutches and full weight as tolerated for at least the first two weeks, then progress to one and then off, once you can walk without a limp and without pain.
When can I go back to work?
Most patients with a desk job return around two weeks. Between four and eight weeks you can be out in the community for thirty to sixty minutes at a time, without heavy lifting at home or work.
When can I run again?
Not before twelve weeks. That restriction is about the risk of a fracture after surgery while the reshaped bone is healing. Between eight and twelve weeks most patients are walking a couple of hours comfortably, and the average patient feels about 60 to 70 percent by ten to twelve weeks.
When can I get back to my sport?
Six months, after passing a sport test. Some things come back sooner. Golf, putting and chipping, is usually around four months. The test matters more than the date: it is what shows the hip is ready.
Does FAI surgery have risks?
Yes, as any surgery does. Numbness around the incisions, over the outer thigh, or in the foot is common early on and normal. Other issues we watch for are stiffness in hip flexion, irritation of the psoas tendon, blood clots, and infection. You are given specific signs to watch for and who to call. Dr. Swann reviews the risks with you for your own hip before anything is scheduled.
What happens if FAI is left alone?
Impingement keeps loading the same spot every time the hip bends. Over time that tears the labrum and wears the cartilage at the rim. Treating it is about protecting the joint you still have, which is why it belongs in hip preservation and not in the replacement conversation.
Is this the same surgery as a PAO?
No. A PAO repositions a shallow socket to treat hip dysplasia and is open surgery with a longer recovery. FAI surgery is arthroscopic and reshapes bone that is in the way. Some hips have both problems, and Dr. Swann will tell you which one is driving your pain. A PAO is a more involved surgery than arthroscopic FAI surgery.
Call to Action
Getting a pinch in the front of your hip?
Schedule an evaluation with Dr. Presley Swann to find out whether impingement is what is causing it.
Call 720-475-3355 · Text 720-445-6836
The information on this page is for general education and is not medical advice. Every hip is different. For guidance about your own hip, please schedule an evaluation with Dr. Swann.