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Hip

The hip joint is one of the most important joints in the human body. It allows us to walk, run, and jump. It bears our body’s weight and the force of the strong muscles of the hip and leg. The hip joint is also one of our most flexible joints and allows a greater range of motion than all other joints in the body except for the shoulder.

A hip injury can often be devastating to a person’s quality of life. At Orthopedic Associates of Dutchess County we have a vast team of board-certified orthopedic surgeons, doctors and pain management specialists whose goal is to get you mobile again in the fastest and safest way possible. Our providers are specialty-trained to quickly diagnose your cause of pain and establish a course of treatment that meets your individual needs and goals.

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Meet Our

Hip Team
Frank Lombardo, M.D.
ORTHOPEDIC KNEE & HIP REPLACEMENT SURGEON
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Russell Tigges, M.D.
ORTHOPEDIC KNEE & HIP REPLACEMENT SURGEON
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John McLaughlin, M.D.
HIP, KNEE & SHOULDER REPLACEMENT SURGEON / SPORTS MEDICINE
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Kenneth K. Rauschenbach, D.O.
KNEE, HIP & SHOULDER REPLACEMENT SURGEON / SPORTS MEDICINE / GENERAL ORTHOPEDICS / TRAUMA
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Michael Rutter, M.D.
ORTHOPEDIC HIP & KNEE REPLACEMENT AND TRAUMA SURGEON
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William Barrick, M.D.
ORTHOPEDIC SPINE SURGEON / TRAUMA / GENERAL ORTHOPEDICS
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Richard B. Perkins, M.D
ORTHOPEDIC SPINE SURGEON
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Richard Dentico, M.D.
PAIN MANAGEMENT / REGENERATIVE MEDICINE / HAIR RESTORATION / VEIN DISEASE
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Karl Ziermann, D.O.
SPORTS MEDICINE / CONCUSSION MANAGEMENT SPECIALIST / OSTEOPOROSIS MANAGEMENT SPECIALIST Schedule
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Vishal P. Rekhala, D.O.
SPECIALIZING IN PAIN MANAGEMENT / VEIN DISEASE / REGENERATIVE MEDICINE
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Damien Faillace, RPA-C
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Jean Walsh, MS, FNP-C, CEN
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Landon Brown, MD
ORTHOPEDIC KNEE & HIP REPLACEMENT SURGEON
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An acetabular fracture is a break in the socket portion of the “ball-and-socket” hip joint. These hip socket fractures are not common – they occur much less frequently than fractures of the upper femur or femoral head (the “ball” portion of the joint).

The majority of acetabular fractures are caused by some type of high-energy event, such as a car collision. Many times patients will have additional injuries that require immediate treatment.

In a smaller number of cases, a low-energy incident, such as a fall from standing, may cause an acetabular fracture in an older person who has weaker bones.

Treatment for acetabular fractures often involves surgery to restore the normal anatomy of the hip and stabilize the hip joint.

Symptoms

A fractured acetabulum is almost always painful. The pain is worsened with movement.

If nerve damage has occurred with the injury, the patient may feel numbness, weakness, or a tingling sensation down the leg.
A painful, burning sensation on the outer side of the thigh may mean that one of the large sensory nerves to your legs-the lateral femoral cutaneous nerve (LFCN)-is being compressed. This condition is known as meralgia paresthetica (me-ral’-gee-a par-es-thet’-i-ka).

The nerves in your body bring information to the brain about the environment (sensory nerves) and messages from the brain to activate muscles (motor nerves). To do this, nerves must pass over, under, around, and through your joints, bones, and muscles. Usually, there is enough room to permit easy passage.

In meralgia paresthetica, swelling, trauma, or pressure can narrow these openings and squeeze the nerve. When this happens, pain, paralysis, or other dysfunction may result.

Symptoms

  • Pain on the outer side of the thigh, occasionally extending to the outer side of the knee
  • A burning sensation, tingling, or numbness in the same area
  • Occasionally, aching in the groin area or pain spreading across the buttocks
  • Usually only on one side of the body
  • Usually more sensitive to light touch than to firm pressure
Femoroacetabular impingement (FAI) is a condition in which extra bone grows along one or both of the bones that form the hip joint – giving the bones an irregular shape. Because they do not fit together perfectly, the bones rub against each other during movement. Over time this friction can damage the joint, causing pain and limiting activity.

Symptoms

The most common symptoms of FAI include:

  • Pain
  • Stiffness
  • Limping
Pain often occurs in the groin area, although it may occur toward the outside of the hip. Turning, twisting, and squatting may cause a sharp, stabbing pain. Sometimes, the pain is just a dull ache.
Your thighbone (femur) is the longest and strongest bone in your body. Because the femur is so strong, it usually takes a lot of force to break it. Motor vehicle collisions, for example, are the number one cause of femur fractures.

The long, straight part of the femur is called the femoral shaft. When there is a break anywhere along this length of bone, it is called a femoral shaft fracture. This type of broken leg almost always requires surgery to heal.

The most common types of femoral shaft fractures include:

Transverse fracture. In this type of fracture, the break is a straight horizontal line going across the femoral shaft.

Oblique fracture. This type of fracture has an angled line across the shaft.

Spiral fracture. The fracture line encircles the shaft like the stripes on a candy cane. A twisting force to the thigh causes this type of fracture.

Comminuted fracture. In this type of fracture, the bone has broken into three or more pieces. In most cases, the number of bone fragments corresponds with the amount of force needed to break the bone.

Open fracture. If a bone breaks in such a way that bone fragments stick out through the skin or a wound penetrates down to the broken bone, the fracture is called an open or compound fracture. Open fractures often involve much more damage to the surrounding muscles, tendons, and ligaments. They have a higher risk for complications-especially infections-and take a longer time to heal.

Symptoms

A femoral shaft fracture usually causes immediate, severe pain. You will not be able to put weight on the injured leg, and it may look deformed-shorter than the other leg and no longer straight.
The bones of children and adults share many of the same risks for injury. But because they are still growing, a child’s bones are also subject to a unique injury called a growth plate fracture. Growth plates are areas of cartilage located near the ends of bones. Because they are the last portion of a child’s bones to harden (ossify), growth plates are particularly vulnerable to fracture.

Approximately 15% to 30% of all childhood fractures are growth plate fractures. Because the growth plate helps determine the future length and shape of the mature bone, this type of fracture requires prompt attention. If not treated properly, it could result in a limb that is crooked or unequal in length when compared to its opposite limb. Fortunately, serious problems are rare. With proper treatment, most growth plate fractures heal without complications.

Symptoms

A growth plate fracture usually causes persistent or severe pain. Other common symptoms include:

  • Visible deformity, such as a crooked appearance of the limb
  • An inability to move or put pressure on the limb
  • Swelling, warmth, and tenderness in the area around the end of the bone, near the joint
  • Bursae, are small, jelly-like sacs that are located throughout the body, including around the shoulder, elbow, hip, knee, and heel. They contain a small amount of fluid, and are positioned between bones and soft tissues, acting as cushions to help reduce friction.
  • Bursitis is inflammation of the bursa. There are two major bursae in the hip that typically become irritated and inflamed. One bursa covers the bony point of the hip bone called the greater trochanter. Inflammation of this bursa is called trochanteric bursitis.
  • Another bursa – the iliopsoas bursa – is located on the inside (groin side) of the hip. When this bursa becomes inflamed, the condition is also sometimes referred to as hip bursitis, but the pain is located in the groin area. This condition is not as common as trochanteric bursitis, but is treated in a similar manner.


Symptoms

The main symptom of trochanteric bursitis is pain at the point of the hip. The pain usually extends to the outside of the thigh area. In the early stages, the pain is usually described as sharp and intense. Later, the pain may become more of an ache and spread across a larger area of the hip.

Typically, the pain is worse at night, when lying on the affected hip, and when getting up from a chair after being seated for a while. It also may get worse with prolonged walking, stair climbing, or squatting.
  • A traumatic hip dislocation occurs when the head of the thighbone (femur) is forced out of its socket in the hip bone (pelvis). It typically takes a major force to dislocate the hip. Car collisions and falls from significant heights are common causes and, as a result, other injuries like broken bones often occur with the dislocation.

    A hip dislocation is a serious medical emergency. Immediate treatment is necessary.

    Symptoms

    A hip dislocation is very painful. Patients are unable to move the leg and, if there is nerve damage, may not have any feeling in the foot or ankle area.
  • A hip fracture is a break in the upper quarter of the femur (thigh) bone. The extent of the break depends on the forces that are involved. The type of surgery used to treat a hip fracture is primarily based on the bones and soft tissues affected or on the level of the fracture.

    Symptoms

    The patient with a hip fracture will have pain over the outer upper thigh or in the groin. There will be significant discomfort with any attempt to flex or rotate the hip.

    If the bone has been weakened by disease (such as a stress injury or cancer), the patient may notice aching in the groin or thigh area for a period of time before the break. If the bone is completely broken, the leg may appear to be shorter than the noninjured leg. The patient will often hold the injured leg in a still position with the foot and knee turned outward (external rotation).
  • A hip strain occurs when one of the muscles supporting the hip joint is stretched beyond its limit or torn. Strains may be mild, moderate, or severe, depending on the extent of the injury. A severe strain can limit your ability to move your hip.

    Anyone can experience a hip strain just doing everyday tasks, but strains most often occur during sports activities.

    Although many hip strains improve with simple home treatment, severe strains may require physical therapy or other medical treatment.

    Symptoms

    A muscle strain causes pain and tenderness in the injured area. Other symptoms may include:

    • Increased pain when you use the muscle
    • Swelling
    • Limited range of motion
    • Muscle weakness
There are more than 100 different forms of arthritis, a disease that can make it difficult to do everyday activities because of joint pain and stiffness.

Inflammatory arthritis occurs when the body’s immune system becomes overactive and attacks healthy tissues. It can affect several joints throughout the body at the same time, as well as many organs, such as the skin, eyes, and heart.

There are three types of inflammatory arthritis that most often cause symptoms in the hip joint:
  • Rheumatoid arthritis
  • Ankylosing spondylitis
  • Systemic lupus erythematosus


Although there is no cure for inflammatory arthritis, there have been many advances in treatment, particularly in MLS Laser Therapy or the development of new medications. Early diagnosis and treatment can help patients maintain mobility and function by preventing severe damage to the joint.

Symptoms

Inflammatory arthritis may cause general symptoms throughout the body, such as fever, loss of appetite and fatigue. A hip affected by inflammatory arthritis will feel painful and stiff. There are other symptoms, as well:

  • A dull, aching pain in the groin, outer thigh, knee, or buttocks
  • Pain that is worse in the morning or after sitting or resting for a while, but lessens with activity
  • Increased pain and stiffness with vigorous activity
  • Pain in the joint severe enough to cause a limp or make walking difficult
Sometimes called “wear-and-tear” arthritis, osteoarthritis is a common condition that many people develop during middle age or older. In 2011, more than 28 million people in the United States were estimated to have osteoarthritis. It can occur in any joint in the body, but most often develops in weight-bearing joints, such as the hip.

Osteoarthritis of the hip causes pain and stiffness. It can make it hard to do everyday activities like bending over to tie a shoe, rising from a chair, or taking a short walk.

Because osteoarthritis gradually worsens over time, the sooner you start treatment, the more likely it is that you can lessen its impact on your life. Although there is no cure for osteoarthritis, there are many treatment options to help you manage pain and stay active.

Symptoms

The most common symptom of hip osteoarthritis is pain around the hip joint. Usually, the pain develops slowly and worsens over time, although sudden onset is also possible. Pain and stiffness may be worse in the morning, or after sitting or resting for a while. Over time, painful symptoms may occur more frequently, including during rest or at night. Additional symptoms may include:

  • Pain in your groin or thigh that radiates to your buttocks or your knee
  • Pain that flares up with vigorous activity
  • Stiffness in the hip joint that makes it difficult to walk or bend
  • “Locking” or “sticking” of the joint, and a grinding noise (crepitus) during movement caused by loose fragments of cartilage and other tissue interfering with the smooth motion of the hip
  • Decreased range of motion in the hip that affects the ability to walk and may cause a limp
  • Increased joint pain with rainy weather
Osteonecrosis of the hip is a painful condition that occurs when the blood supply to the head of the femur (thighbone) is disrupted. Because bone cells need a steady supply of blood to stay healthy, osteonecrosis can ultimately lead to destruction of the hip joint and severe arthritis.

Osteonecrosis is also called avascular necrosis (AVN) or aseptic necrosis. Although it can occur in any bone, osteonecrosis most often affects the hip. More than 20,000 people each year enter hospitals for treatment of osteonecrosis of the hip. In many cases, both hips are affected by the disease.

Symptoms

Osteonecrosis develops in stages. Hip pain is typically the first symptom. This may lead to a dull ache or throbbing pain in the groin or buttock area. As the disease progresses, it becomes more difficult to stand and put weight on the affected hip, and moving the hip joint is painful.

It may take from several months to over a year for the disease to progress. It is important to diagnose osteonecrosis early, because some studies show that early treatment is associated with better outcomes.

 

Posted in on January, 2022