Hip Conditions
Osteoarthritis of the Hip
Osteoarthritis, also called degenerative joint disease, is the most common form of arthritis. It occurs most often in the elderly. This disease affects the tissue covering the ends of bones in a joint called cartilage. In osteoarthritis, the cartilage becomes damaged and worn out, causing pain, swelling, stiffness and restricted movement in the affected joint.
Hip Bursitis
Hip bursitis is a painful condition caused by the inflammation of a bursa in the hip. Bursae are fluid-filled sacs present in the joints between bone and soft tissue to reduce friction and provide cushioning during movement.
Hip Fracture
A hip fracture is a break that occurs near the hip in the upper part of the femur or thighbone. The thighbone has two bony processes on the upper part - the greater and lesser trochanters. The lesser trochanter projects from the base of the femoral neck on the back of the thighbone.
Hip Instability
Injury or damage to these structures can lead to a condition called hip instability when the joint becomes unstable.
Hip Labral Tear
A hip labral tear is an injury to the labrum, the cartilage that surrounds the outside rim of your hip joint socket.
Hip Ligament Injuries
Injuries to the hip ligaments are commonly called a hip sprain and can range from minor tears of the ligaments to more serious injuries involving the hip muscles, tendons or bone.
Iliopsoas Tendonitis
Iliopsoas tendonitis also referred to as snapping hip syndrome, is an inflammation of the iliopsoas tendon or the surrounding area. The iliopsoas is the hip flexor tendon located over the front of the hip socket. The term snapping hip describes the sound made, a snap or click, that occurs with certain hip movements including flexion, extension, and rotation of the hip.
Femoroacetabular Impingement
Femoroacetabular impingement (FAI) is a condition characterized by excessive friction in the hip joint from the presence of bony irregularities. These cause pain and decreased range of hip motion.
Hip Osteonecrosis
Hip osteonecrosis occurs due to disruption of the blood supply to the highest part of the thigh bone (femoral head). Due to lack of nourishment, the bone tissue of the femoral head dies and gradually collapses, which may further lead to degeneration of the underlying cartilage.
Snapping Hip Syndrome
Snapping hip syndrome is a condition in which you hear or feel a snapping sound in the hip when you swing your legs, run, walk or get up from a chair. The sound can be experienced in the back, front or side of the hip.
Hip Synovitis
Hip synovitis, also called transient hip synovitis or toxic synovitis, is a condition characterized by inflammation of the synovial tissues that surround the hip joint. It is the most common cause for sudden hip pain that occurs in young children between the age of 2 and 9.
Hip Procedures
Direct Anterior Total Hip Replacement
Direct anterior hip replacement is a minimally invasive hip surgery to replace the hip joint without cutting through any muscles or tendons as against traditional hip replacement that involves cutting major muscles to access the hip joint.
Outpatient Hip Replacement
Hip replacement surgery is one of the most common orthopedic surgeries performed. It involves the replacement of the damaged hip bone (ball shaped upper end of the femur) with a ceramic ball attached to a metal stem that is fixed into the femur and placing a new cup with a special liner in the pelvis.
Hip Cartilage Restoration
Hip cartilage restoration is a surgical technique to repair damaged articular cartilage in the hip joint by stimulating new growth of cartilage or by transplanting cartilage into areas with defects in order to relieve pain and restore normal function to the hip.
Hip Preservation Surgery
The hip is a ball and socket joint comprising of the femur (thigh bone) and the pelvic bone. The head of the femur (ball) articulates with a cavity (socket) called the acetabulum in the pelvic bone.
Hip Arthroscopy
Hip arthroscopy, also referred to as keyhole or minimally invasive surgery, is a procedure in which an arthroscope is inserted into your hip joint to check for any damage and repair it simultaneously.
Minimally Invasive Total Hip Replacement
Minimally invasive total hip replacement is a surgical procedure performed through one or two small incisions rather than the single long incision of 10–12-inches as in the traditional approach.
Hip Trauma Reconstruction
Hip trauma is an injury in the hip due to the impact caused by incidents such as a car accident or a hard fall. The injury can be a bone break or dislocation or both.
Hip Labral Repair
Labral tear may be caused by trauma, femoroacetabular impingement (FAI), hip hypermobility, dysplasia, and degeneration. It is one of the rare conditions and is common in athletes playing sports such as ice hockey, soccer, golf, and ballet.
Hip Cartilage Repair
Hip cartilage repair is the process of restoring damaged cartilage in the hip joint, either surgically or non-surgically.
Hip Fracture Surgery
Surgical correction of a hip fracture is known as hip fracture surgery. Hip fractures involve a break that occurs near the hip in the upper part of the femur or thigh bone. The thigh bone has two bony processes on the upper part - the greater and lesser trochanters.
Revision Hip Replacement
Revision hip replacement is a complex surgical procedure in which all or part of a previously implanted hip joint is replaced with a new artificial hip joint. Total hip replacement surgery is an option to relieve severe arthritis pain that limits your daily activities.
Ultrasound Guided Hip Injections
An ultrasound scan is an imaging procedure that uses high-frequency sound waves to produce pictures of the inside of the body. Ultrasound-guided hip joint injections are used to diagnose the underlying cause and relieve hip pain.
Physical Therapy for Hip
Physical therapy is an exercise program that helps you to improve movement, relieve pain, encourage blood flow for faster healing, and restore your physical function and fitness level. The main aim of physical therapy is to make your daily activities, such as walking, getting in and out of bed and climbing stairs, easier.
Hip Anatomy
Hip Joint
The hip joint is the largest weight-bearing joint in the human body. It is also referred to as a ball and socket joint and is surrounded by muscles, ligaments, and tendons. The thigh bone or femur and the pelvis join to form the hip joint.
Any injury or disease of the hip will adversely affect the joint's range of motion and ability to bear weight.
The hip joint is made up of the following:
- Bones and joints
- Ligaments of the joint capsule
- Muscles and tendons
- Nerves and blood vessels that supply the bones and muscles of the hip
Bones and Joints
The hip joint is the junction where the hip joins the leg to the trunk of the body. It is comprised of two bones: the thigh bone or femur and the pelvis which is made up of three bones called ilium, ischium, and pubis. The ball of the hip joint is made by the femoral head while the socket is formed by the acetabulum. The Acetabulum is a deep, circular socket formed on the outer edge of the pelvis by the union of three bones: ilium, ischium, and pubis. The lower part of the ilium is attached by the pubis while the ischium is considerably behind the pubis. The stability of the hip is provided by the joint capsule or acetabulum and the muscles and ligaments which surround and support the hip joint.
The head of the femur rotates and glides within the acetabulum. A fibrocartilagenous lining called the labrum is attached to the acetabulum and further increases the depth of the socket.
The femur or thigh bone is one of the longest bones in the human body. The upper part of the thigh bone consists of the femoral head, femoral neck, and greater and lesser trochanters. The head of the femur joins the pelvis (acetabulum) to form the hip joint. Next, to the femoral neck, there are two protrusions known as greater and lesser trochanters which serve as sites of muscle attachment.
Articular cartilage is the thin, tough, flexible, and slippery surface lubricated by synovial fluid that covers the weight-bearing bones of the body. It enables smooth movements of the bones and reduces friction.
Ligaments
Ligaments are fibrous structures that connect bones to other bones. The hip joint is encircled with ligaments to provide stability to the hip by forming a dense and fibrous structure around the joint capsule. The ligaments adjoining the hip joint include:
- Iliofemoral ligament: This is a Y-shaped ligament that connects the pelvis to the femoral head at the front of the joint. It helps in limiting the over-extension of the hip.
- Pubofemoral ligament: This is a triangular shaped ligament that extends between the upper portion of the pubis and the iliofemoral ligament. It attaches the pubis to the femoral head.
- Ischiofemoral ligament: This is a group of strong fibers that arise from the ischium behind the acetabulum and merge with the fibers of the joint capsule.
- Ligamentum teres: This is a small ligament that extends from the tip of the femoral head to the acetabulum. Although it has no role in hip movement, it does have a small artery within that supplies blood to a part of the femoral head.
- Acetabular labrum: The labrum is a fibrous cartilage ring which lines the acetabular socket. It deepens the cavity, increasing the stability and strength of the hip joint.
Muscles and Tendons
A long tendon called the iliotibial band runs along the femur from the hip to the knee and serves as an attachment site for several hip muscles including the following:
- Gluteals: These are the muscles that form the buttocks. There are three muscles (gluteus minimus, gluteus maximus, and gluteus medius) that attach to the back of the pelvis and insert into the greater trochanter of the femur.
- Adductors: These muscles are located in the thigh which helps in adduction, the action of pulling the leg back towards the midline.
- Iliopsoas: This muscle is located in front of the hip joint and provides flexion. It is a deep muscle that originates from the lower back and pelvis and extends up to the inside surface of the upper part of the femur.
- Rectus femoris: This is the largest band of muscles located in front of the thigh. They also are hip flexors.
- Hamstring muscles: These begin at the bottom of the pelvis and run down the back of the thigh. Because they cross the back of the hip joint, they help in extension of the hip by pulling it backward.
Nerves and Arteries
Nerves of the hip transfer signals from the brain to the muscles to aid in hip movement. They also carry the sensory signals such as touch, pain, and temperature back to the brain.
The main nerves in the hip region include the femoral nerve in the front of the femur and the sciatic nerve at the back. The hip is also supplied by a smaller nerve known as the obturator nerve.
In addition to these nerves, there are blood vessels that supply blood to the lower limbs. The femoral artery, one of the largest arteries in the body, arises deep in the pelvis and can be felt in front of the upper thigh.
Hip Movements
All of the anatomical parts of the hip work together to enable various hip movements. Hip movements include flexion, extension, abduction, adduction, circumduction, and hip rotation.