Arthritis of the Hip
As with all joints, movement of the hip is permitted by smooth cartilage that allows for minimum friction when walking or standing. Unfortunately, as a result of injury, wear and tear, and other conditions, arthritis can develop when that cartilage breaks down. Arthritis of the hip is a condition in which there is loss of the cartilage of the head of the thigh bone and of the cup-shaped socket of the pelvis where the thigh bone fits into the joint. Cartilage doesn’t heal when damaged, so the body attempts to heal by making more bone, resulting in irregular joints and/or bone spurs. Arthritis is often accompanied by dull pain with motion or activity, and tends to get worse when the hip joint is strained by walking long distances, standing for a long period of time, or climbing stairs. In order to relieve pain and restore function, we start with conservative approaches like physical therapy or steroid injections. If these treatments fail to provide relief, surgery may be necessary.
A bursa is a fluid-filled sac that reduces friction between tendons and bones. Bursitis is caused by inflammation of this bursa; bursitis of the hip could be a result of a direct blow to the bursa from a fall, constant pressure from lying on that side, or repeated stress during activity. There are four bursa surrounding the hip joint that can be affected, with the most commonly injured being the trochanteric bursa, located on the outside of the hip. Symptoms of bursitis include pain and tenderness over the location of the bursa, pain during activities, and swelling, often accompanied by loss of motion of the hip. Conservative treatment options for hip bursitis can include medication to reduce discomfort, nonsteroidal medication, drainage, and injection. Surgery can also be done to remove the affected bursa.
A hip dislocation occurs when the thigh bone, or the femur, is dislodged from the hip socket. The femur can be pushed backward, resulting in posterior dislocation, or forward, as anterior dislocation. Posterior dislocation will leave the foot and knee rotated inward, and anterior dislocation will result in a slightly bent hip and the leg rotated out. This injury is usually the result of impact, like a fall or car accident. Signs of a dislocated hip include hip pain and difficulty putting weight on the affected leg. You may experience numbness or weakness on the side of the hip dislocation Following a dislocation, it is important to move the hip joint back into proper position as soon as possible to prevent complications; this is called a reduction, and will be performed by your doctor. Medication and physical therapy may also be used to reduce pain and return strength and range of motion following the injury. Surgery may be necessary if there are any bone fragments that may be getting in the way of a smooth reduction.
A hip fracture involves a break in the thigh bone, or femur, where it meets the pelvic bone. Hip fractures usually result from a fall, and are often obvious due to the resulting abnormal position of the hip and leg. Signs of a hip fracture include inability to get up from a fall or to walk, severe pain in the hip or groin, inability to put weight on the affected side, bruising or swelling in the hip area, and an outward turning of the leg on the injured side. A hip fracture almost always requires surgical repair or replacement. Treatment for a hip fracture is usually a combination of surgery, rehabilitation, and medication. Your doctor can repair the broken bones with an internal repair using screws, or a total or partial hip replacement.