What is Femoroacetabular Osteoplasty (FAO)?

Femoroacetabular osteoplasty is the surgical reshaping of the protruding bony surface of the femur or acetabulum of the hip joint. FAO is performed arthroscopically as a minimally invasive procedure. An arthroscope is a small, fibre-optic instrument consisting of a lens, light source, and video camera. The camera projects images of the inside of the joint onto a monitor, allowing your surgeon to look for damage, assess the type of injury and perform needed repairs.

Indications

FAO is indicated for femoroacetabular impingement, abnormal growth of the femur (ball) or the acetabulum (socket) of your hip joint, causing the bones to rub against each other. The common symptoms of femoroacetabular impingement include pain and stiffness in the groin, hip and thigh region, lower-back pain and an inability to bend the hip.

Preparation

Your doctor will advise you on any medications you need to stop taking prior to the procedure. You should tell your doctor if you are allergic to any medicines or anaesthesia. Your medical history will be taken, and tests may be conducted such as X-ray, CT-scan or MRI. Certain blood tests may also be ordered.

Surgical Procedure

The surgery is performed under general anaesthesia and includes the following steps:

  • You will lie on your back (supine position).
  • Internal rotation of the limb is performed by your surgeon, which enables the placement of the arthroscope into the hip joint.
  • Arthroscopic portals are inserted through a small incision.
  • Your surgeon performs diagnostic arthroscopy to confirm the extent of bone overgrowth.
  • Debridement, or cleaning out the bone tissue, is performed using a surgical shaver.
  • Labral reconstruction using grafts may be performed to repair a damaged labrum, the rubbery tissue that keeps the ball of the joint in place.
  • The incisions are closed and a bandage is applied.

Complications of the Surgery

Complications are rare but can occur with any surgery and can include:

  • Damage to joint cartilage or the labrum
  • Injury to nearby nerves or blood vessels.
  • Small risk of infection
  • Blood clots or DVT
  • Complications from anaesthesia

Recovery after Surgery

Your rehabilitation protocol may include:

  • A combination of non-steroidal anti-inflammatory drugs (NSAIDs) and opioids to manage pain.
  • Your leg will be placed in a brace and you will be encouraged to keep weight off your leg for a short period of time.
  • You are not allowed to lift heavy objects or perform any activity that may stress your hamstring muscles for a few weeks.
  • Physiotherapy exercises will be taught to enhance your flexibility, range of motion and strength.

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