HIP

THE HIP

The hip is a “ball-and-socket” joint, where the “ball” at the top of the femur (thigh bone) fits inside the “socket” of the acetabulum (pelvis). The hip joint is normally lubricated by a natural substance in the body called cartilage, but if the bone and/or cartilage of the hip become diseased or damaged, the joint can stiffen and be very painful. The hip is the single most important aspect good posture and a large variety of issues can develop from poor posture; therefore, it is extremely important to have a strong, healthy hip area.
Many hip conditions can be treated through conservative methods, however, surgery is often needed due to the excessive weight and forces put on the joint simply when walking, standing and performing other day-to-day activities, not to mention more aggressive activities.

COMMON CONDITIONS

Hip Fractures

A hip fracture is a crack or break at the top of the femur (thigh bone) where the bone angles inward toward the hip joint. There are two types of hip fracture: intertrochanteric fracture and femoral neck fracture. Any breaks that occur further down the bone are classified as a broken femur rather than a broken hip. If the break is two to four inches from the joint, it is known as an intertrochanteric fracture. A femoral neck fracture is identified by a fracture that is within two inches of the joint. It is generally the femoral neck fracture that may require more extensive surgery.

Patients suffering from a hip fracture usually find it too painful to stand and the affected leg may even turn outward or shorten as a result of the injury. These types of fractures generally require hospitalization and surgical repair followed by physical therapy.

Risk factors for suffering a hip fracture increase for those who are over 65 and for women, due to osteoporosis. Other populations susceptible to hip fractures are those who are physically or mentally impaired, small-boned, smoke, use alcohol excessively, have a family history of hip fractures, take medications that cause weakness or dizziness, or have osteoporosis or low calcium – which leads to bone weakness.

Labral Tears

The acetabulum, or hip socket, is the concave surface of the pelvis that is covered with a layer of cartilage called the labrum. This cartilage cushions and deepens the hip socket to help stabilize the joint. A traumatic injury, repetitive movement or tissue degeneration may cause the labrum to tear. This can be the result of osteoarthritis, hip impingement, hip dislocation, or twisting and pivoting – as in baseball.

A labral tear can be subtle and may cause no symptoms nor require treatment; however, on the other end of the spectrum, tears may cause pain in the hip, stiffness, limited motion, and a feelings of the joint clicking, locking or catching.

COMMON PROCEDURES

Arthroscopy

Hip arthroscopy is a minimally invasive procedure that can be used to diagnose and treat a wide variety of conditions affecting the hip joint. By giving doctors a clear view of the inside of the hip, arthroscopy procedure is useful for confirming the diagnosis of various imaging procedures, x-rays and MRIs for instance, as it provides your doctor with a three-dimensional, real time look at the affected area.

When undergoing a 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 fiber-optic camera at its tip, into the hip joint. The camera displays a video feed of what is seen on a screen, and your surgeon is able to use this internal view to confirm diagnosis. If damage is detected, it can be attended to immediately by inserting surgical instruments into the incisions during the same procedure. Through this operation, your surgeon can replace or smooth damaged cartilage, join together torn tissue, trim bone spurs, remove of bone and tissue fragments, or realign the hip joint to reduce pain and inflammation.

Arthroscopic techniques can often be used to treat conditions such as:

  • Arthritis
  • Cartilage damage
  • Labral tear
  • Removal of bone and tissue fragments
  • Snagging hip syndrome

Hip arthroscopy offers patients many advantages over traditional surgery. A fiber-optic camera and surgical instruments are inserted into the body through several small, carefully placed incisions, so the procedure is minimally invasive, effectively decreases the amount of bleeding during surgery, has reduced risk of infection or other complications, and minimizes scarring.

Hip Fracture Repair

Hip fractures are often extremely painful and require surgical repair to restore proper function

and put an end to pain. A hip fracture can range from a hairline crack or to a complete break at the top of the femur (thigh bone) where the bone angles inward toward the hip joint. Hip fractures become more common in older patients and those with osteoporosis or other similarly degenerative diseases.

A hip fracture surgery involves making an incision to reach the affected area and then realigning the fractured bones. This is often done through Open Reduction Internal Fixation (ORIF), which relies on metal pins, screws, rods or plates put in place to secure the bones as they heal. The incision is then closed with sutures or staples. This procedure typically takes two to four hours to perform and the hardware may or may not be removed later on.

Total Hip Replacement

Hip replacement is usually a last resort treatment for patients who suffer from constant, debilitating hip pain. This includes those with arthritis, fractures, bone death or other conditions.

In this procedure, the affected bone and cartilage are removed completely and the head of the femur (thigh bone) is replaced with a metal ball and the acetabulum (hip socket) is replaced with a plastic cup.

The new, artificial joint, called a prosthesis, may either be cemented in place, be cementless, or may be a hybrid of both. In most cases, these prosthetic devices can offer pain relief and restored function for 25 years or longer.

PROCEDURE VIDEOS

TOTAL HIP ANIMATION

TOTAL HIP REPLACEMENT