• Dr. Domb!

    Thanks a lot for getting my hip right. Looking forward to a full recovery and a great season. Thanks again for everything.

    Corey WoottonChicago Bears and Detroit Lions
  • Thank you for all that you have done for me and the team. My hip feels so much better, and because of you I'm pain free.
    Sylvia Fowles WNBA Finals MVP, 2-time Olympic Gold Medalist
  • Thank you for working your magic! You're the best!
    Zakiya BywatersChicago Red Stars, National Women's Soccer League
  • Thanks for all the love and positive Energy that was put into my surgery. May the Lord bless you and your family.
    Atari BigbyGreen Bay Packers and San Diego Chargers
  • Dr. Domb, Thanks for fixing me up
    Rashied DavisChicago Bears
  • Huge thank you to Dr. Domb for always taking care of me and getting me back on the court in no time!
    Elena Delle DonneChicago Sky, MVP of the WNBA
  • Dr. Domb! Thanks for taking care of the hip! All the best to you and your staff
    Roosevelt ColvinChicago Bears' All-Decade Defense team
  • Thanks doc for fixing my hip!
    Ryan ChiaveriniWindy City Live Co-Host on ABC7

Femoro-Acetabular Impingement

Femoro-acetabular Impingement (FAI) is a common generator of pain in the hip. Impingement can lead to labral tears and eventually advancement of osteoarthritis. Impingement is most commonly described as anatomic bony variability of the acetabulum (socket) and femur (leg bone) that causes the two bones to rub against each other during certain hip motions.

There are two distinct forms of hip impingement: too deep or over-coverage of a socket, known as Pincer impingement and a non-spherical femoral head, known as Cam impingement.

Some hips have both Pincer and Cam impingement, known as Combined impingement. During hip motion, either during sports or with daily activities, the non-spherical femoral head and socket can continually meet and rub against each other, causing pinching or entrapment of the labrum, commonly leading to a labral tear or joint wear-and-tear.

Labral tears can be repaired arthroscopically. When repairing a labral tear, the mechanical, or bony, impingement must also be addressed.  Arthroscopic treatment involves trimming the overhang of the acetabular rim, known as an acetabuloplasty and shaving down the bump on the femoral neck, known as a femoroplasty. A femoroplasty involves re-shaping of the femoral head to restore its spherical contour. Both procedures help restore the ability of the ball-and-socket joint to move in all directions without the friction of impingement.

Treatment of Femoro-Acetabular Impingement

Iliopsoas Impingement

Iliopsoas Impingement

Image: Normal psoas tendon (left) and tight psoas tendon (right) causing impingement

The iliopsoas (hip flexor) muscle runs along the front of the hip, connecting the spine to the femur. With iliopsoas impingement, the muscle and tendon of the iliopsoas become tight. In many cases, this is associated with a "snapping hip," in which the iliopsoas tendon snaps over the labrum and femoral head. The tightness of the iliopsoas causes rubbing against the labrum which can cause irritation and tearing.

Sex Based Differences in Presentations of Hip Pain 2014

Open Surgical Dislocation versus Arthroscopic Treatment of FAI

Hip Impingement Identifying and Treating a Common Cause of Hip Pain 2009

Open Surgical Dislocation versus Arthroscopy for Femoroacetabular Impingement, Comparison of Clinical Outcomes 2011

Publications by Dr. Domb on Impingement

Hip arthroscopy: Treatment of Pincer and Cam type femoroacetabular impingement:

Hip arthroscopy: acetabular rim trimming for a pincer lesion

Hip arthroscopy: osteoplasty for cam lesion decompression

Hip arthroscopy: Chondroplasty and osteoplasty of cam lesion

Hip arthroscopy revision arthroscopy of a twice operated hip

FAI and SCFE screw removal and osteoplasty - Hip arthroscopy