- Anatomy
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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. Although osteoarthritis may affect various joints including the hips, knees, hands, and spine, the hip joint is most commonly affected. Rarely, the disease may affect the shoulders, wrists, and feet.
Inflammatory Arthritis of the Hip
The inflammation of the joints is referred to as arthritis. Inflammation arises when the smooth lining called cartilage at the ends of bones wears away. In some cases, the inflammation is caused when the lining of the joint becomes inflamed as part of an underlying systemic disease. These conditions are referred to as inflammatory arthritis.
Hip Injury
The hip joint is prone to several types of injuries. Common ones include:
- Fracture
- Bursitis
- Dislocation
- Labral tear
Hip Pain
Hip pain, one of the common complaints, may not always be felt precisely over the hip joint rather in and around the hip joint. The cause for pain is multifactorial and the exact position of your hip pain suggests the probable cause or underlying condition causing it.
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.
A tear in the labrum of the hip can result from:
- Traumatic injury, such as a motor vehicle accident
- Participating in sports such as football, soccer, basketball and snow skiing
- Repetitive movements
- Weight-bearing activities over time, which can lead to joint wear and tear
- Degenerative changes to the hip joint in the elderly
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 fractures can occur either due to a break in the femoral neck, in the area between the greater and lesser trochanter or below the lesser trochanter.
Hip Dislocation
The hip joint is a “ball and socket” joint. The “ball” is the head of the femur or thighbone, and the “socket” is the cup-shaped acetabulum. The joint is surrounded by muscles, ligaments, and tendons that support and hold the bones of the joint in place. Hip dislocation occurs when the head of the femur moves out of the socket. The femoral head can dislocate either backward (posterior dislocation) or forward (anterior dislocation).
Hip Instability
Hip instability can be traumatic or atraumatic. Traumatic instability can be caused by injuries from sports or motor vehicle accidents. These injuries can damage the bony structures, labrum, and cartilage of the hip joint and form loose bodies. It can range from severe dislocation to a simple subluxation (partial displacement) of the hip joint. Atraumatic instability can be caused by overuse or developmental/congenital abnormalities of the hip joint.
Avascular Necrosis
Avascular necrosis, also called osteonecrosis, is a condition in which bone death occurs because of inadequate blood supply to it. Lack of blood flow may occur when there is a fracture in the bone or a joint dislocation that may damage nearby blood vessels. Hip joint is most commonly affected; however, the knee and shoulder may also be involved.
Developmental Dysplasia
Developmental dysplasia of the hip (DDH) or hip dysplasia is a condition that is seen in infants and young children because of developmental problems in the hip joint. The femur (thighbone) partially or completely slips out of the hip socket leading to dislocation at the hip joint. It is most common in the first-born baby with a family history of the disorder.
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.
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.
Hamstring Injuries
The hamstring is a group of three muscles that run along the back of the thigh from the hip to the knee. Hamstring injuries occur when these muscles are strained or pulled. They are common in dancers and athletes of all sorts including runners and those who play football, soccer, basketball, tennis, etc.
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.
Femur Fracture
The femur or thigh bone is the longest and strongest bone in the body, connecting the hip to the knee. A femur fracture is a break in the femur. The distal femur is the lower part of the thigh bone which flares out like an upside-down funnel and its lower end is covered by a smooth, slippery articular cartilage that protects and cushions the bone during movement. Fracture of the distal femur may involve the cartilaginous surface of the knee as well and result in arthritis.
Pelvic Fractures
A pelvic fracture is a condition that occurs due to the breakage of the pelvic bone. It may cause damage to the internal organs, nerves and blood vessels associated with the pelvic region.
Hip Tendonitis
Tendons are strong connective tissue structures that connect muscle to bone. Hip tendonitis is a condition associated with degeneration of the hip tendons. This condition is mainly caused due to strain on the tendons which may occur due to overuse or biomechanical problems.
Gluteus Tendon Tear
The gluteal muscles (situated in the buttocks) are necessary for the stability and movement of the hip joints. The tendons of two gluteal muscles (gluteus medius and gluteal minimus) are attached at the outer hip region and are often called the “rotator cuff of the hip.” These tendons may be subject to injury or tearing due to various reasons.
Hip Abductor Tears
Hip abductors are a major group of muscles found in the buttocks. It includes the gluteus maximus, gluteus medius, gluteus minimus, and tensor fascia lata muscles.
Hip Adductor Injuries
Hip adductors are the group of muscles on the inner side of your thigh that enable adduction or the ability to bring the thighs together.
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.
Hip Flexor Strain
A hip flexor strain is an overuse injury to the flexor muscles of your hip and can range from a minor stretch injury to a complete tear of the muscle fibers or tendons.
Stress Fractures of the Hip
Stress fractures of the hip are a break in the upper part of the thigh bone (femur) that fits into the socket of the hip joint. It can occur in any part of the hip, however, it mostly occurs just below the ball of the ball-and-socket hip joint called the femoral neck.
Avulsion Fractures of the Pelvis
Avulsion fractures of the pelvis is an injury that occurs when a tendon or ligament pulls off a piece of bone from the hip. This results in a part of the pelvic (hip) bone breaking away from the main part of the bone.
Femoral Neck Fracture
The hip is a ball-and-socket joint made up of the head of the thigh bone or femur that acts as the ball and fits into the rounded socket of the hip bone or acetabulum. The neck of the femur is the region just below the ball of the hip joint.
Subtrochanteric 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 fractures can occur either due to a break in the femoral neck, in the area between the greater and lesser trochanter or below the lesser trochanter.