The size of the hip joint helps to keep it safe from injury by outside
forces, but over time stress and chronic conditions can lead to growing
pain that is hard to escape.
While shifts in habits can often help patients avoid joint pain, the structure
of the hip and pelvis can make simply sitting or lying down a painful
experience for those with hip injuries.
Sauk Prairie Healthcare’s Orthopedic surgeons specialize in relieving hip pain and, with a team of nurses and therapists,
help to get patients back on their feet as soon as possible.
Hip Anatomy
The hip is the connection of the femur, or thighbone, to the pelvis in
a ball-and-socket joint. The femur is both held in position and given
smooth circular motion with an arrangement of cartilage and tendons.
Inside the socket of the hip joint, there is a ring of cartilage called
the labrum that follows the outer edge of the socket. The labrum acts
as a cushion to protect the hip joint, and form a protective seal to keep
the top of the femur in place.
There are also sets of hip joint ligaments connecting the pelvic bone to
the bones in the legs. Each of these ligaments stabilize the hip joint
and allows it the full range of motion. Similarly, the tendons in the
hip connect the muscles around the hip to the femur and pelvic bones.
Common Hip Conditions
Hip Fracture
There are three main kinds of hip fractures:
Femoral neck fracture — making up about half of hip fractures, in
which the hip breaks just below the ball of the ball-and-socket joint
Intertrochanteric fracture — a break near the top of the hip, where
the bone juts in toward the joint
Subtrochanteric fracture — an injury lower in the hip and more commonly
caused by high-force trauma and found among young men injured in sports
Hip fractures are usually the result of a fall from a standing position.
The patient often has mobility issues at the time, which make the force
and damage of the fall all the more significant.
In the event of less dramatic, stable hairline fractures, the injury may
go largely unrecognized, but symptoms include a pain radiating in the
area of the groin or the upper thigh. Some stable fractures are not detectable
by an X-ray and require an MRI scan.
Surgery is often recommended so the patient can become mobile again. Without
surgery, bed rest and immobility can lead to further problems, especially
in the elderly.
In cases of a stable fracture, an Orthopedic surgeon will often secure
the bone and joint with screws. Depending on the severity of the fracture,
and age and activity level of the patient, an Orthopedic surgeon may recommend
partial or full hip replacement as an option that may be less likely to
require more treatment in the future.
If a patient is in good health, hip fracture surgery often involves an
overnight stay in the hospital, followed by a temporary stay in a skilled
rehabilitation facility, and then three to four weeks of outpatient rehabilitation.
Some patients can go directly home from the hospital if they have enough
of a support system.
While this may result in “functional” recovery, some orthopedic
experts recommend continued physical therapy and strength training in
the following months to help get the injured hip back to doing most or
all pre-fracture activities. Some patients do not get back to their pre-injury
level of function after a hip fracture; nevertheless, that is still the goal.
Hip Arthritis
Over 54 million adults in the United States are estimated to have doctor-diagnosed
arthritis, according to the Arthritis Foundation. Although there are dozens
of varieties of arthritis, the Orthopedic surgeons of Sauk Prairie Healthcare
and around the country primarily see osteoarthritis, avascular necrosis,
rheumatoid arthritis, and arthritis due to dysplasia of the hip.
Rheumatoid arthritis is an autoimmune condition which causes the body’s
immune system to attack the lining of a joint, such as the hips, causing
swelling and chronic pain.
Osteoarthritis, or degenerative joint disease, is chronic pain caused by
wear and tear of the cartilage between the joints. Osteoarthritis is the
most common condition treated by Orthopedic surgeons at Sauk Prairie Healthcare.
Avascular necrosis (AVN), or osteonecrosis, is a lack of good blood flow
to the hip joint, resulting in degeneration. This can occur with no known
cause, though the condition has also been connected with use of steroid
medication, excessive alcohol consumption, or a previous fracture.
Dysplasia is a malformation of the shape of the hip that occurs during
development. When a person has hip dysplasia the hip socket doesn’t
fully cover the ball of the femur, making the joint prone to abnormal
forces or instability. These in turn lead to arthritic changes.
In these cases, a doctor will often begin with conservative treatments
to manage pain and reduce swelling, as well as strengthen the supporting
muscles with exercise or physical therapy. If conservative treatment is
unsuccessful, your Orthopedic surgeon may recommend total
hip replacement surgery.
Hip Labral Tear
A hip labral tear is a tear in the ring of cartilage lining the socket
of your hip joint.
Sometimes, hip labral tears display no signs or symptoms. However, when
there are symptoms, they can include pain in the hip or groin. Other hip
labral tear symptoms include:
A locking, clicking or popping sensation
Stiffness
Limited mobility and range of motion
A sensation that the hip is weak or wants to give way when bearing weight
Groin pain and less often pain in the side of the hip or buttocks
Labral tears are often associated with other hip bone issues such as dysplasia
and femoracetabular impingement, or FAI. Many times patients notice these
conditions by the common symptom of a deep groin pain.
Labral cartilage can protect the hip from the onset of arthritis in the
future. To repair a labral tear, the Orthopedic surgeon will remove the
damaged tissue, while leaving healthy cartilage in place. This repair
can be done arthroscopically, using small tools guided by a tiny camera
through a small incision.
An Orthopedic surgeon will discuss if surgical labral tear treatment is
right for you and what options may be available. Physical therapy may
also help you strengthen your hip after surgery.
Hip surgery patients who have received arthroscopic treatment often begin
recovery using crutches to get around for the first couple weeks after
surgery, but they may require at least 6 weeks without weight-bearing.
Multiple weeks of physical therapy are required, and lingering post-operative
hip pain can occur over several months.
Greater Trochanteric Pain Syndrome
The gluteus medius and gluteus minimus (abductors) are two muscles which
can be subject to injuries or stress. This can cause pain on the lateral
side or the outside of the hip. These muscles help rotate the thigh bone
and keep the hip and pelvis stable when your foot is on the ground.
This can become more difficult when there is damage to the abductor tendons
that connect these muscles to either side of the hip joint. The tendons
can become irritated or inflamed, causing pain. Additionally, inflammation
of the fluid over the abductor tendons can occur and this is called “trochanteric
bursitis.”
Trochanteric bursitis and trochanteric pain syndrome are common conditions
that are often treated with physical therapy and sometimes injections.
On rare occasions surgery is performed when non-surgical treatment is
not effective.
How Sauk Prairie Healthcare Treats Hip Conditions
Sauk Prairie Healthcare’s Orthopedic surgeons treat a range of hip
conditions. Treatment options include less invasive procedures, such as
physical therapy, medications, and injections. For the right patients,
hip replacement surgery (arthroplasty) has been proven to give significant
pain relief and dramatic improvement in quality of life. This can be done
with a variety of surgical approaches at Sauk Prairie Healthcare, including
the anterior approach.
Our Orthopedic surgeons are supported by a team of physical therapists,
physician assistants, and nurse practitioners who help you get back on
your feet again.
Orthopedic Surgery, OrthopedicsView Profile
