The pain of impingement may progress to the point where it interferes with activities of daily living. Treatment first consists of trying to control the pain with over the counter anti-inflammatory medications and Tylenol. If this does not control the pain sufficiently, surgical treatment may be warranted.
Hip arthroscopy involves correcting the cause of impingement and dealing the damage that has occurred the hip labrum as well as possible cartilage of the hip joint. Hip arthroscopy is the most common method of accessing the joint. The procedure allows the surgeon to visualize as well as treat the damaged area. Damage to the labrum is addressed with partial removal and possible repair.
The bony problems leading to this impingement are then addressed. This may involve removing a portion of the bone in the front of the hip socket. X-ray is used during the procedure to remove the correct amount as well as to visualize the motion of the hip during bone shaping. Bone at the junction of the head and neck of the thigh bone are then visualized, and the bone is shaped to create the proper offset necessary for smooth movement. Again, x-ray and hip motion are used to correctly remove bone in the critical area.
In cases of more severe malposition of the hip socket, a redirecting procedure, called a periacetabular osteotomy (PAO) may be required. This is in more severe cases of impingement where bone removal alone would not adequately address the problem.