HIP

The hip is a ball-and-socket type joint. The thigh bone (femur) has a ball-shaped knob on the end that fits into a socket formed in the hip bone. The hip joint is a major weight-bearing joint, supporting a stress load of up to five times your body weight when you are walking. It takes a good deal of force to seriously damage the hip. This is because the hip is surrounded by the large muscles of the thighs and the fact the the femur itself is the largest bone in the body.

ORTHOPAEDIC SERVICES FOR THE HIP

TYPICAL HIP INJURIES AND ILLNESSES

STRAIN

Whereas a sprain is an injury involving a stretched or torn ligament, when your muscle fibers are overused or torn through repetitive or overly strenuous activity, the resulting injury is called a strain.

Commonly, the approach to relieving muscle strain in the hip is known by its acronym, RICE.

REST – Consider using crutches to avoid putting weight on your hip.
ICE – Gently apply ice to the area to help decrease swelling.
COMPRESSION – Compression shorts or an elastic (ACE™) bandage may help.
ELEVATION – Raise and rest the hip area.

Your doctor may also recommend anti-inflammatories or acetominophen, if not contraindicated, to reduce swelling and ease pain.

BURSITIS

Throughout the body, your joints are cushioned by small fluid-filled sacs called bursae. Healthy bursae help create a smooth gliding between bone and muscle, but when they become inflammed, moving your hip joint becomes painful.

The rounded outer edge of your femur is called the greater trochanter. The greater trochanter has a particularly large bursa to enable your hip to move. Inflammation of this large bursa, or bursitis, is often brought on through repetitive movement, such as running, cycling, or even standing.

Bursitis can also be the result of an injury, arthritis, and bone spurs that irritate the bursae with inflammation. It is also frequently a consequence of an awkward gait, especially if one of your legs is shorter than the other.

Many people with hip bursitis can experience relief with simple lifestyle changes, including avoiding the activities that worsen symptoms, temporarily using a walking cane or crutches, or the use of anti-inflammatory medicines.

Injection of a steroid medicine may also alleviate your bursitis. This simple and effective treatment can be done in your doctor’s office.

OSTEOARTHRITIS

Like other joints that bear your weight, your hips may be at risk for “wear and tear” arthritis (osteoarthritis). This happens when the cartilage on the ends of your bones wears thin.

If you do not get treatment for osteoarthritis of the hip, the condition will continue to worsen. Bone spurs might build up at the edges of the joint. Eventually, the cartilage may wear away completely, leaving the bones to rub directly against each other. This makes it very painful for you to move.

If you become less active to avoid the pain, the muscles controlling your joint get weak, and you may start to limp.

While you cannot reverse osteoarthritis, early treatment may help you avoid pain and slow progression of the disease. One common step is to follow a physical therapy program of gentle, regular exercise to keep your joint functioning. Another approach is to lose weight if you are overweight. Using a cane can also be beneficial.

If you have later stages of osteoarthritis your doctor may recommend total hip replacement surgery called arthroplasty.

DISLOCATION

A hip dislocation occurs when the head of your femur slips out of its socket in the pelvis. A hip dislocation is very painful.

A hip dislocation can have long-term consequences, if it disrupts the blood vessels as it moves out of socket. When blood supply to the bone is lost, the bone can die. The protective cartilage covering the bone may also be damaged, which increases the risk of developing arthritis in the joint.

To address a dislocated hip, your physician will manipulate the bones back into their proper position. This process is called a reduction. In some cases the reduction must be done in the operating room with anesthesia.

FRACTURES

ABOUT HIP FRACTURES

A hip fracture is a break in the upper quarter of your femur or thighbone. It may also involve a break in the socket or acetabulum in the pelvis. Normally, the bones require a great deal of force to break, but some medical conditions such as osteoporosis can weaken the bone and make the hip more susceptible to fracture.

The thin section of your thigh bone that connect the ball end of the bone to the main shaft is called the femoral neck. If this is where your hip is broken, it can cut off blood supply and lead to severe joint damage. Treatment for femoral neck fractures can be successfully achieved through a surgical procedure that replaces one half of the hip joint with a prosthetic, while leaving the other half intact.

ABOUT HIP SURGERY

Most hip fractures require surgical intervention to help the bones heal. These surgeries may involve surgical steel hardware such as compression screws, or in some cases implants to replace the damaged bone.

Because of the nature of hip surgery, many patients may find that a brief stay in a rehabilitation facility is necessary to assist them in regaining their ability to walk. The physical therapist will work with you to help you regain strength and learn how to safely return to normal activities.

DEVELOPMENTAL DYSPLASIA

Developmental dysplasia of the hip (DDH) is an abnormal formation of the hip joint. In DDH, the ball and socket are loose rather than firmly connected.
DDH tends to run in families. It is predominant in first-born girls and babies born in the breech position. While some babies born with a dislocated hip will show no outward signs, legs of different lengths, limping, toe-walking or a duck-like gait are all indicators of DDH.

Given the very real possibility of a limp, early onset of arthritis in the joint, and impaired mobility later in life, pediatricians screen for DDH at a newborn’s first examination and at every well-baby checkup thereafter. When the condition is detected at birth, it can usually be corrected through traction, casting or surgical intervention. However, even with appropriate treatment, hip deformity and osteoarthritis may develop later in life.

HIP REPLACEMENT

Hip replacement surgery is a safe and effective procedure (also called total hip arthroplasty) that can relieve your pain, increase motion, and help you get back to enjoying everyday activities.

In a total hip replacement, the damaged bone and cartilage is removed and replaced with prosthetic components. Southlake Orthopaedic surgeons routinely perform this procedure with outstanding results.

ARTHRITIS

Generally speaking, arthritis means inflammation of a joint, whether the result of a disease, an infection, a genetic defect, or some other cause. Although more than 100 types of arthritis have been identified, there are two primary types of arthritis that may affect your hips: osteoarthritis and rheumatoid arthritis (RA).

In addition to pain, the arthritis inflammation may produce fever or swelling at the affected joint. You may also feel a sensation of grating or grinding; this crepitation is caused by damaged cartilage surfaces rubbing against one another.

One form of treatment for arthritis is a steroid injection. These typically provide pain relief for several weeks. However, possible harmful side effects limit the number of times these types of injections can be used.

If nonsurgical treatment is unsuccessful, there are many surgical options to consider. If there is any way the joint can be preserved or reconstructed, this method is usually chosen. When the damage is severe enough, a joint replacement or a fusion (arthrodesis) is performed. As with any surgical procedure, you should consult with an orthopaedist who is well versed in current surgical techniques and discuss the best option for your particular needs.

HIP