The hip is a “ball-and-socket” joint where the “ball” at the top of the thigh bone (femur) fits inside the “socket” of the pelvis (acetabulum). A natural substance in the body called cartilage lubricates the joint. When the bone and/or cartilage of the hip become diseased or damaged, the joint can stiffen and be very painful.
While many hip conditions can be treated through conservative methods, surgery is often needed because of the excessive weight placed on the joint while walking, standing and performing other regular activities.
Hip Fractures A hip fracture is a break in the top of the femur (thighbone) where the bone angles toward the hip joint. If the break occurs within two inches of the joint, it is called a femoral neck fracture. If it occurs between two and four inches from the joint, it is known as an intertrochanteric fracture. (A break further down the bone is classified as a broken femur rather than a broken hip.) Femoral neck fractures require more extensive surgery.
Hip fractures usually make it too painful for the person to stand. The leg may turn outward or shorten. They generally require hospitalization and surgical repair.
A person’s risk for suffering a hip fracture increases if he or she is over 65, female, or small-boned; has a family history of hip fractures; has osteoporosis or low calcium, which leads to bone weakness; smokes or uses alcohol excessively; is physically or mentally impaired; or takes medications that cause weakness or dizziness. Hip fractures are a common and serious problem for the elderly, for whom a simple fall in the home may be enough to break the bone.
Labral Tears The hip socket, or acetabulum, is covered with a layer of cartilage called the labrum that cushions and deepens the socket to help stabilize the joint. The labrum may tear due to a traumatic injury (e.g. hip dislocation), repetitive movement (e.g. twisting or pivoting, such as in golf) or tissue degeneration (e.g. osteoarthritis or hip impingement). Sometimes, a labral tear causes no symptoms and doesn’t require treatment. However, tears may cause pain in the hip as well as stiffness, limited motion, and a sense that the joint is locking, clicking or catching.
Treatments and Procedures
Arthroscopy Hip arthroscopy is a minimally invasive procedure used to diagnose and treat a wide range of conditions affecting the hip joint. This procedure can be used to confirm the diagnosis of various imaging procedures, such as X-rays and MRIs, as it provides your doctor with a three-dimensional, real time imaging of the affected area, allowing for the most accurate diagnostic results. If damage or abnormalities are detected during the diagnostic procedure, repairs can often be made during the same procedure, offering patients many advantages over traditional surgery.
Arthroscopic techniques can often be used to treat conditions such as:
- Labral tear
- Loose bodies
- Snagging hip syndrome
- Cartilage damage
During the hip arthroscopy procedure, your surgeon will make a small incision near the affected area of the hip and insert an arthroscope, a long flexible tube with a camera on the end that displays images of the inside of the hip joint to detect any damage. If damage is detected, it can be repaired during the same procedure by inserting surgical instruments through a few other incisions. Your surgeon can replace damaged cartilage, join together torn ends, remove loose bodies or realign the joint to minimize pain and inflammation.
Hip Fracture Repair A hip fracture involves a break in the top of the femur when the bone angles toward the hip joint. Hip fractures are especially common in older patients and those with osteoporosis. They are usually extremely painful and require surgical repair to relieve pain and restore proper functioning.
During hip fracture surgery, an incision is made over the affected area and the bones are aligned back in place. The bones are often held in place with metal pins, screws, rods or plates while they heal, which may or may not be removed later on. The incision is then closed with sutures or staples. This procedure usually takes two to four hours to perform.
Total Hip Replacement Hip replacement is usually a last resort treatment for patients with severe hip pain whose daily lives are affected by the pain, including those with arthritis, fractures, bone death or other conditions. In this procedure, the diseased bone and cartilage are replaced with a metal ball and plastic cup.
The artificial joint, called a prosthesis, may be cemented in place, may be cementless, or may be a hybrid of both. The prosthetic devices provide pain relief and restored function for 25 years or longer in most cases.
Who to Contact
Upon setting up an appointment, the below doctors can answer your questions and concerns regarding various conditions and treatment options: