The hip is a ball and socket joint, and it plays an important role in supporting the weight of your body and helping you to retain balance. Over time, cartilage in your hip can wear away or become damaged, causing the bones to rub and grind together. This causes much of the hip pain and stiffness patients feel.
Although people frequently associate joint pain with an injury or fracture to the hip, other common causes of a damaged hip include:
- Breakdown of the joint's cartilage (osteoarthritis)
- Cartilage injuries
- Decay of the bone from long-term use of alcohol or steroids (necrosis)
- Tear in the gluteus medius muscle (gluteus medius syndrome)
- Deformity of the ball or socket (hip impingement)
- Hip tears
- Inflamed and stiff cartilage (rheumatoid arthritis or gout)
- Tear in the hip joint cartilage (labral tear)
- Bone and/or cartilage fragments (loose bodies) floating in the joint
- Snapping hip
Many hip problems can be managed with physical therapy, medication and/or rehabilitation; however, depending on your situation, your orthopedic specialist may recommend hip surgery or hip replacement surgery to correct the problem.
Many hip problems are related to tendonitis, bursitis and athletic injuries. People who suffer from these or other injuries or conditions may benefit from hip arthroscopy, a minimally invasive outpatient surgical procedure. Instead of a large incision, your doctor can make three or four small incisions to repair your hip, allowing for a faster and less painful recovery.
During this procedure, your physician places a small camera into your hip joint through one small incision, and tiny instruments used to treat the underlying problem are placed though the other incisions. Your physician will shave and remove excess bone and also repair the cartilage.
Most patients need to use crutches for two to six weeks following the procedure, and you can usually return to sports and other high-intensity activities in three to four months. When other conservative measures to relieve pain have not been effective, talk with your surgeon to see if you are a candidate.
Hip Replacement Surgery
Hip replacement surgery is often needed in cases of severe degenerative joint disease or other cases where the hip is too damaged to treat it with conservative measures. The goal of hip replacement surgery is to help relieve your pain and improve your quality of life.
In a total hip replacement surgery, the painful parts of your damaged hip are replaced with artificial hip parts called a prosthesis, a device that substitutes or supplements a joint. The prosthesis consists of three components: a socket, ball and stem. The outer shell of the socket is usually made of metal with the inner shell consisting of plastic, but the entire socket may be plastic in some cases. When the metal ball is joined with the socket, the new hip allows for smooth, nearly frictionless movement.
In an anterior hip replacement, the surgeon reaches your hip joint from the front of the hip, which means no muscle needs to be detached. This minimally invasive surgery allows for easier recovery and rapid return to normal functions. Anterior hip replacement surgery allows you to immediately bend your hip freely and bear full weight when comfortable.
The recovery process from total hip replacement will take time. Your orthopedic surgeon will work with you to develop a rehabilitation plan that begins while you’re still in the hospital and continues until you feel completely healed. Typical recoveries include physical therapy exercises to regain your strength, pain management and learning safe new ways to move and bend.
MedStar Orthopaedic Institute specialists at MedStar St. Mary's Hospital now offer cutting-edge treatment for hip arthritis in younger patients. When younger patients are faced with severe hip pain due to arthritis, dysplasia (hip abnormality) or avascular necrosis (death of bone tissue), they have an option that may be more successful than a total hip replacement: the bone-conserving Birmingham Hip Resurfacing system.
In this procedure, your surgeon cleans away the damaged surfaces on your affected hip bones instead of completely removing the hip components. The damaged surfaces are replaced with highly durable material that actually helps strengthen the hip joint, allowing bone to grow around it.
Compared with total hip replacement, hip resurfacing offers many benefits for patients younger than 60 who would like to remain active, including:
- Patients experience greater postoperative stability, which is a key component of hip surgery as it dramatically decreases the chance of dislocation.
- The materials used to create the Birmingham Hip are designed to reduce joint wear.
- This procedure allows surgeons to conserve more of the your bone, which makes concerns about leg length discrepancy virtually nonexistent.
- Because the femoral head and neck are preserved by the hip resurfacing technique, you can still have a total hip replacement in the future, if necessary.
- After a solid year of recovery, you are able to return to your favorite activities, such as jogging or tennis—unlikely feats with a total hip replacement.
Hip replacements are designed to last your entire life. However, replacements can wear out due to natural use over time or to an infection that can develop in nearby tissues. Hip revisions remove old hip implants that may have become a problem and replace them with new ones. This type of hip replacement surgery requires extraordinary skill to remedy the initial replacement, and the physicians at the MedStar Orthopaedic Institute have extensive experience performing these procedures.
Infected Total Joints
If a total joint replacement becomes infected, the health of the joint and limb, as well as your overall health, become an immediate concern. Not all orthopedic specialists are trained to manage and treat infected total joints, but the orthopedic surgeons at the MedStar Orthopaedic Institute have experience appropriately managing and aggressively treating infections. This often requires removal of the total joint implant and a course of antibiotics, followed by revision joint replacement. This procedure is critical for removing the bacteria from your system and maximizing your overall health.
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