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Hip Impingement (FAI) Surgery

Hip Impingement (FAI) Surgery

Groin pain that will not settle, assessed as a hip joint problem. Structured rehabilitation first; hip arthroscopy with labral repair where cartilage is preserved.

Femoroacetabular impingement is the reason a lot of young, active adults have hip or groin pain that no one can explain. Extra bone on the femoral neck (cam morphology), on the socket rim (pincer morphology), or both, causes the two to abut at the ends of movement. Over time that repeated contact tears the labrum — the rim of tissue sealing the socket — and damages the adjacent cartilage.

It is routinely misdiagnosed as a groin strain that will not settle, as a “hip flexor problem”, or as early arthritis in someone far too young for it. Dr. Nitin N Sunku assesses hip impingement with a focused examination, dedicated hip imaging and the measurements that actually matter, and is explicit about the one thing that decides everything: how much cartilage is left. Where the joint space is preserved, hip arthroscopy can genuinely change the trajectory. Where it is not, arthroscopy is the wrong operation, and you will be told that.

Conditions We Treat

Cam-Type Impingement

Extra bone at the head-neck junction of the femur, so the femoral head is not perfectly round. Typical in men in their twenties and thirties, and in people who played pivoting or kicking sport through adolescence. Pain deep in the groin on flexion and internal rotation — putting on socks, getting out of a car, sitting for a long drive.

Pincer-Type Impingement

Over-coverage of the socket rim, so the neck of the femur strikes the rim at the end of movement. More common in active women. Often presents as a persistent deep ache after activity rather than a sharp catch, with pain reproduced when the hip is flexed and rotated.

Labral Tears

The consequence of impingement in most cases, rather than an isolated injury. Patients describe catching, clicking, or a sharp pinch in the groin, sometimes with a feeling of the hip locking momentarily. Treating the labral tear without addressing the bone that caused it is a well-recognised route to a repeat tear.

Groin Pain That Has Not Settled

Athletes and active adults carrying a “groin strain” for six months or more, sometimes after multiple courses of physiotherapy. The examination distinguishes hip joint pain from adductor, hernia-related and lumbar-referred causes, which is often the step that has been skipped.

The C-sign is characteristic: patients cup the hand around the side and front of the hip to show where it hurts. Pain pointed to with one finger over the outer bone, or pain that runs down the back of the thigh, usually points elsewhere.

Treatment Approach / Procedures Offered

Structured Non-Surgical Management First

For most patients the first line is a targeted programme, not surgery: activity and load modification, deep hip rotator and gluteal strengthening, core and pelvic control work, and correcting the positions that provoke impingement — deep squatting, prolonged low sitting, and end-range flexion under load. A properly delivered programme over three months resolves symptoms for a meaningful proportion of people, and it is a fair trial before any operation is considered.

Diagnostic and Therapeutic Injection

An image-guided intra-articular injection serves two purposes. It can settle symptoms, and it answers a diagnostic question: if pain from inside the hip joint disappears for the duration of the local anaesthetic, that confirms the joint is the source. If it does not, the problem is likely outside the joint, and hip arthroscopy would not have helped.

Hip Arthroscopy — Osteoplasty and Labral Repair

Where symptoms persist despite a genuine rehabilitation trial and imaging confirms impingement with preserved joint space, arthroscopic surgery reshapes the bone (femoral osteoplasty and, where indicated, acetabular rim trimming) and repairs the labrum with anchors rather than simply removing it. Preserving and repairing the labrum matters — it maintains the suction seal that helps the joint distribute load.

When Arthroscopy Is Not the Answer

Hip arthroscopy has a poor record in hips that already show significant joint space narrowing, and in patients whose imaging shows dysplasia rather than impingement. In those situations the honest options are continued non-surgical management, or — where arthritis is advanced and quality of life is genuinely limited — a discussion about joint replacement at the right time. Recommending an arthroscopy on a worn hip to avoid that conversation does the patient no favours.

Why Choose Our Clinic

The value in hip impingement care is almost entirely in patient selection. Dr. Sunku’s arthroscopy and sports medicine fellowship training, and his experience with professional athletes, is applied here to separating the hips that will do well from those that will not — using examination, dedicated imaging and, where useful, a diagnostic injection, rather than operating on an MRI report. A labral tear on a scan is common in people with no pain at all; the decision is made on the whole picture.

Recovery and Rehabilitation Overview

Week 0–2

Crutches with partial weight-bearing to protect the repair, gentle passive range of motion, and early activation work. Specific movements — deep flexion, forced rotation — are restricted to protect the labral repair.

Week 2–6

Weaning off crutches as gait normalises, progressive range of motion within limits, stationary cycling introduced, and gluteal and deep rotator strengthening begun in earnest.

Week 6–12

Full range of motion expected. Strength work loaded properly, single-leg control, and gradual reintroduction of functional movements. Most desk-based patients are fully back at work well before this point.

Month 3–6

Running progression, then agility and sport-specific work as strength and control allow. Recreational activity generally resumes across this window.

Month 6–12

Return to competitive or pivoting sport. Hip arthroscopy rehabilitation is a slower burn than patients expect — improvement continues over the first year rather than plateauing at three months.

Realistic expectation-setting matters more here than in most procedures. The aim is a substantial reduction in pain and a return to activity, not a guaranteed pain-free hip — and outcomes are consistently better in hips with well-preserved cartilage, which is why the pre-operative assessment is so thorough.

Where we see Hip Impingement Patients

Raghava Multispeciality

Centred at Attibele, on Sarjapura–Attibele Road. Ideal for people in Anekal, Chandapura, Jigani, Bommasandra, and Electronic City.

In-person Reviews

Health Nest Hospital

HSR Layout (24th Main, Sector 2). Convenient for HSR, Koramangala, BTM Layout, and Bellandur residents.

Follow-up Visits
If you are unsure which location to book, use the contact page and mention your pin code. Bring prior MRI or X-ray reports, a list of medicines, and comfortable clothing so the joint can be examined properly.

Hip Impingement (FAI) FAQ

Most commonly a deep ache or pinch in the groin, brought on by sitting for long periods, getting in and out of a car, putting on socks and shoes, or deep squatting. Many patients instinctively cup their hand around the side and front of the hip to indicate the pain. Clicking or catching suggests the labrum is involved. Pain over the outer bony point or running down the back of the thigh usually has a different cause.
Not necessarily. Labral tears are found on scans of people with no hip symptoms at all, so the MRI finding alone does not establish the diagnosis. What matters is whether your examination reproduces the pain in the pattern typical of impingement, and — where there is doubt — whether an image-guided injection into the joint temporarily abolishes it. Treating a scan rather than a patient is how unnecessary hip operations happen.
A properly targeted programme resolves symptoms for a meaningful proportion of patients, and it is a fair first line for most people. It focuses on gluteal and deep rotator strength, pelvic control, and avoiding the end-range positions that provoke impingement — it is not a generic hip stretching routine, and generic stretching into flexion can make impingement worse. Surgery is discussed when three months of the right programme has not worked.
That claim is made more often than the evidence supports. Reshaping the bone and repairing the labrum removes the mechanism that is damaging the cartilage, which is a rational reason to believe it helps in a hip with good cartilage. But it is not a guarantee against future arthritis, and in a hip that already shows significant joint space narrowing, arthroscopy performs poorly. You will be given a straight answer about which category your hip falls into.
Crutches for roughly two weeks, desk work within one to three weeks, driving usually at three to four weeks, running around three months, and pivoting sport between six months and a year. Recovery continues improving over the first twelve months — this is not an operation that reaches its final result at three months.
Often they are two stages of the same process. Cam-type impingement is a recognised contributor to hip arthritis developing early, because the abnormal bone shape damages the cartilage over years. Whether the label is impingement or early arthritis matters less than the measurement of how much joint space remains, because that is what determines which treatments are sensible.
Cam morphology is more common in people who played high-impact or pivoting sport during adolescence, while the growth plate was still open. That is an association, not a reason for regret — it simply explains why a fit person in their twenties or thirties can develop a structural hip problem without any single injury.
That is a useful result, not a failed treatment. If anaesthetic inside the joint does not settle the pain, the source is likely outside the joint — the adductors, the abdominal wall, the sacroiliac joint or the lumbar spine — and the assessment shifts accordingly. It also means hip arthroscopy would very probably not have helped, which is worth knowing before rather than after an operation.

Book a Hip Impingement Assessment in Bengaluru

Groin pain that has not settled after months of physiotherapy deserves a hip joint examination and dedicated imaging. Bring your X-rays and MRI if you have them.

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Locations

  • • Raghava Multispeciality, Attibele
  • • Health Nest Hospital, HSR Layout

Related treatments & patient guides

Orthopedic and sports medicine care in Bengaluru

Dr. Nitin N Sunku is a consultant orthopedic surgeon and sports medicine specialist. His day-to-day work spans knee and shoulder arthroscopy, ACL and other ligament injuries, meniscus tears, cartilage-friendly repair options when suitable, hip and knee arthritis assessment, joint replacement when quality of life is clearly limited, fracture and trauma review, and spine symptom evaluation with a staged plan. Care is built around a clear history, a focused examination, imaging only when it changes management, and honest discussion of non-operative versus operative paths.

Where appointments take place

The practice is anchored at Raghava Multispeciality Hospital, Attibele, on Sarjapura–Attibele Road, for many patients travelling from Attibele, Anekal, Chandapura, Jigani, Bommasandra, Electronic City, Sarjapura, and nearby towns who want a South Bengaluru base close to home or work. Health Nest Hospital, HSR Layout (24th Main Road, Sector 2) supports selected consultations and follow-up for people who live closer to HSR, Koramangala, BTM Layout, Bellandur, or Whitefield-side commutes. Both sites link into imaging and physiotherapy networks when referrals are needed.

Conditions and procedures people commonly ask about

Typical questions cover ACL tears and post-injury instability, meniscus repair versus partial trimming, recurrent shoulder dislocation, rotator cuff tears and frozen shoulder, shoulder arthroscopy for impingement, tennis or golfer's elbow flare-ups, runner's knee and shin splints, Achilles and other tendon overuse problems, early to advanced hip and knee arthritis, partial and total knee replacement timing, hip replacement for arthritis and selected fractures, acute collarbone and ankle fractures, workplace and road traffic injuries, and back pain with or without leg symptoms when urgent red flags have been excluded. Sports medicine visits often blend training-load advice with targeted rehabilitation goals rather than rushing to surgery.

Before you attend

Bring photo ID, insurance cards if applicable, a concise list of medicines and allergies, old MRI or X-ray reports on phone or paper, and footwear or clothing that lets the knee or shoulder be examined. Write down three goals—for example, "sleep without waking from knee pain," "jog five kilometres without swelling," or "lift my child safely." Those goals help prioritise whether bracing, injections, structured physiotherapy, arthroscopy, or joint replacement is discussed first.

Using this website responsibly

Articles under the blog section explain common symptoms and treatment concepts in plain language. They are educational, may simplify complex decisions, and should always be confirmed in clinic after examination and, when needed, imaging. If you have severe deformity after injury, numbness or weakness in a limb, high fever with a hot swollen joint, chest pain, shortness of breath, or new bladder or bowel dysfunction with back pain, seek emergency care immediately rather than waiting for an outpatient slot.

You may book through the contact page, call the numbers in the footer, browse services and the gallery for facility context, or read testimonials to understand how recovery plans are communicated. For machine-readable orientation aimed at language models, this site publishes llms.txt.

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