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What is hip impingement?
Femoroacetabular impingement (FAI) is a condition in which bony projections on the femoral head or acetabulum cause pinching of soft tissues (labrum and cartilage) during movement. This leads to chronic cartilage damage, pain, and limited mobility.
FAI is the primary cause of hip osteoarthritis in young people. According to research, impingement is detected in 10-15% of the general population, but manifests clinically with an active lifestyle.
Types of FAI:
- Cam-type — thickening (bump) on the femoral neck. More common in young men and athletes
- Pincer-type — excessive coverage of the femoral head by the acetabulum. More common in middle-aged women
- Mixed-type — combination of cam and pincer (most common — up to 86% of cases)
What is damaged in FAI:
- Acetabular labrum — tear, degeneration
- Acetabular cartilage — detachment, thinning
- Femoral head cartilage — damage from contact
- Joint capsule — chronic inflammation
FAI Facts
- ICD-10: M25.85
- Prevalence: 10-15% of population
- Age: 20-50 years
- Mixed-type: up to 86% of cases
- Consequence: early hip osteoarthritis
Symptoms of hip impingement
Typical Symptoms
- Groin pain with hip flexion and rotation
- Limited joint mobility
- Pain with prolonged sitting
- Pain climbing stairs
- Clicking and locking in the joint
- Worsening after physical activity
Risk Groups
- Athletes (football, hockey, martial arts)
- Dancers and gymnasts
- People with sedentary work (prolonged hip flexion)
- Young active patients aged 20-40 years
Why Treating FAI Is Important
- FAI — primary cause of early hip osteoarthritis (coxarthrosis)
- Without treatment, cartilage destruction is irreversible
- Labral damage progresses
- Earlier treatment — better prognosis
Hip impingement (FAI): treatment options and what is known about them
The treatment plan is made by the clinic doctor after an examination and a review of your images. The table shows the options usually discussed for this diagnosis and how well they have been studied.
| Option | What to expect | How well studied |
|---|---|---|
| Exercise therapy and physiotherapy | Reduces pain, strengthens muscles, improves function; the basis of treatment | Well studied, recommended |
| Load management, weight loss | Takes load off the affected area; if overweight, losing 5–10% noticeably reduces pain | Moderate evidence |
| Painkillers and NSAIDs | Ease pain during flare-ups; long-term use is limited by side effects | Moderate evidence |
| Corticosteroid injection | Quickly reduces inflammation and pain, the effect is often temporary; frequent injections are undesirable | Limited or conflicting evidence |
| PRP / CGF | Concentrate from your own blood; may reduce pain, growth of new tissue has not been shown | Little data |
| Hip arthroscopy | If conservative treatment does not help or there is an indication | When indicated — the doctor decides |
We send your request to several partner clinics. Some will suggest conservative treatment or injections, others surgery; each clinic quotes its own conditions and price. We help you compare the options.
Regenerative methods: realistic expectations
For mechanical joint problems — a labral tear, impingement, instability, ligament injury — targeted rehabilitation is the basis of treatment: muscle strengthening, coordination training and load management. Injections can reduce pain temporarily but do not remove the mechanical cause. There is little data on PRP for these diagnoses.
When surgery is discussed. Surgery is discussed for recurrent dislocations, a marked mechanical cause (bone shape, a large tear) or if pain and instability persist after 3–6 months of rehabilitation.
If an injection helps, the effect usually builds up over 6–12 weeks, and the result is assessed after 2–3 months. No clinic can guarantee a result.
Good to know: diagnosis, self-help, outlook
How to recognise hip impingement
In femoroacetabular impingement the shape of the femoral head (cam) or acetabulum (pincer) causes the bones to abut during hip flexion and internal rotation. Groin pain with deep squatting, prolonged sitting and getting into a car is typical, often in young active people. The diagnosis is confirmed by pelvic X-ray and MR arthrography, which also shows the labrum. Inguinal hernias and adductor-related groin pain in athletes cause similar pain.
What you can do yourself
Avoid deep hip flexion — low seats, deep squats, some yoga positions. Strengthen the gluteal and core muscles and improve pelvic control. Adjust sporting load so that it does not cause groin pain.
Outlook and timelines
Three months of exercise therapy reduces pain in some patients. If pain persists and there is no osteoarthritis, arthroscopy is discussed: reshaping the bone and repairing the labrum; in trials it gave a larger effect than physiotherapy, but not in everyone. With significant osteoarthritis, arthroscopy is of little benefit.
Who it is not suitable for and possible risks
Contraindications
- Active infection — at the injection site or systemic, with fever.
- Active cancer or ongoing chemotherapy.
- Blood clotting disorders or a low platelet count. Anticoagulants are discussed with the physician.
- Pregnancy and breastfeeding — the procedure is usually postponed.
- A corticosteroid injection into the same area in recent weeks.
- Severe stage IV osteoarthritis with axial deformity and joint destruction — joint replacement is usually discussed instead.
Possible risks
- Pain and swelling at the injection site for 1–3 days.
- Bruising where blood or fat tissue is taken.
- Rarely, infection. The procedure is therefore performed under sterile conditions with ultrasound or X-ray guidance.
- The effect may be absent or smaller than expected.
If any of these apply to you, mention it in your request. The coordinator will check with the clinic physician whether treatment is possible. Contact a coordinator.
Scientific evidence
Studies of regenerative methods show mixed results. Clinic physicians rely on research including the following:
- Ye Y et al. Platelet rich plasma versus hyaluronic acid in patients with hip osteoarthritis: A meta-analysis of randomized controlled trials. Int J Surg, 2018.
- Bannuru RR et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage, 2019.
Next steps: Treatment methods · Treatment cost · How treatment in Germany is organised
Frequently Asked Questions About Hip Impingement Treatment
RegenPAS is a patient service centre in Munich, not a clinic. We review your images and symptoms and send a request to several partner clinics at once. Clinics that can accept you send their own conditions and price; prices differ between clinics, and you choose the option that suits you. The coordinator replies within 24 hours, and a clinic physician’s preliminary opinion follows in 1–3 business days. We then arrange the appointment, visa invitation, interpreter, transfers and accommodation. Treatment decisions are made by the clinic physician. Contact a coordinator.
Your MRI (or CT, X-ray) report and the images if you have them, plus a short description of your symptoms and previous treatment. Send them via the form on the website — the assessment is free and without obligation: the coordinator replies within 24 hours, and the clinic physician’s preliminary opinion follows in 1–3 business days.
The cost depends on the method, the diagnostics needed and the clinic itself: prices differ between clinics. We request offers from several clinics and send you their conditions and quotes so you can compare. Price guidance is on the treatment cost page. For an outpatient procedure, 2–3 days in Munich are usually enough: examination, procedure and follow-up visit.
Clinic and method matching — free of charge
Describe your case and attach your MRI report. We will identify clinics that use the relevant methods and forward your request to them. No obligation; we reply within 24 hours.
Send a request