The hip is a "ball-and-socket" joint where the "ball" at the top of the thigh bone (femur) fits inside the "socket" in the pelvis (acetabulum). A layer of smooth cartilage covers the bone ends in a healthy hip joint, allowing you to walk and move your leg easily. When the bone and/or cartilage of the hip becomes diseased or damaged, the joint can stiffen and be very painful.
The most common type of arthritis of the hip is osteoarthritis. In this disease, the cartilage in the hip, especially the acetabular labrum, gradually wears away with use and time. Patients with arthritis of the hip may find relief in a number of non-surgical treatments before considering replacement surgery. The goals of these treatments are to relieve pain, to increase mobility and restore quality of life. Treatments for osteoarthritis include:
Rheumatoid arthritis is another type of arthritis that affects the hip. In rheumatoid arthritis, the hip becomes inflamed and cartilage may be destroyed. Treatment includes:
Avascular Necrosis (AVN) is a disease resulting from the temporary or permanent loss of blood flow to the bone. This can lead to the destruction of the bone and severe reduction in functionality of the joint. AVN is especially common in the hip and can be treated several ways:
Bursitis is the painful swelling of the bursae, which are fluid filled sacs that cushion the areas where tendons and muscles slide across bone. Specific to the hip is trochanteric bursitis which refers to the bursa by the head of the femur. This shock absorbing sac can become agitated and swollen for unknown reasons or as a symptom of other issues such as changes in walking patterns, uneven leg length, or Iliotibial Band Syndrome. Steps can be taken to prevent bursitis by strengthening the core and hips through a moderate training program. Orthotic inserts for people with flat feet can also help. The condition can be treated by:
If the pain and stiffness of the hip joint is severe and other treatments have not brought sufficient relief, a hip replacement may be recommended. Our doctors will conduct a thorough examination that includes x-rays, strength and range-of-motion tests, your medical history and a series of questions to determine whether a total hip replacement is right for you.
Joint replacement surgery removes the damaged, painful parts of the hip and replaces them with a prosthesis made of metal and plastic. The artificial joint can relieve pain and improve mobility when your natural hip can no longer do its job. An artificial ball and metal stem replaces the worn head of the thigh bone and a metal cup and artificial liner replaces the worn socket of the pelvis. The prosthesis allows the hip joint to move smoothly, so patients can enjoy a greater range of pain-free movement.
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 can require more extensive surgery.
Hip fractures usually make it too painful for the person to stand. The leg may turn outward or shorten. They 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.