Hip injuries can be scary and intimidating, especially for elderly patients. The pain that comes along with common hip conditions like arthritis or bursitis can have a negative impact on all aspects of life, keeping many patients from getting a good night’s sleep or from leaving the house for very long. At Union County Orthopaedic Group, we are just as dedicated to helping patients understand and feel comfortable with their hip treatments as we are to providing the highest quality health care. Our orthopedic surgeons have guided countless patients through comprehensive hip treatment plans, including surgical and non-surgical methods that help them recover a pain-free life.
When surgery is the best possible option for our patients with hip injuries, our surgeons provide top-rated orthopedic skill and expertise that patients throughout the New Jersey and New York area seek. Our hip specialists have years of experience performing surgeries with the most successful and modern techniques in hip orthopedics to ensure that you feel your best and walk pain-free, with the confidence that you did prior to the injury.
Common Hip Conditions and Injuries:
- Degenerative Arthritis
- Trochanteric Bursitis
- Femoral Acetabular Impingement Syndrome
- Hip Dislocations
- Hip Instability
- Hip Impingement
- Labral Tears
- Gluteus Medius Tears
Common Treatments of Hip Conditions:
- Total Hip Replacement (Arthroplasty)
- Revision Total Hip Replacement (Arthroplasty)
Anatomy of the Hips
Our hips are the main joints that keep us balanced and keep our spine aligned as we do anything from sitting to walking to playing sports. Because they support our entire upper body, our hip joints need to be sturdy and stable. These weight-bearing ball and socket joints are durable, but after years of wear and tear or injuries that affect our gait (i.e. poor posture, knee injuries), they often become susceptible to natural degenerative conditions like osteoarthritis.
Our pelvic bones are two large bones on either side of our bodies connecting our lower back to our hips. The top of the pelvic bones, or iliums, are attached to the sacrum, or area of the spine under our lumbar spine, via two sacroiliac joints. These joints are immobile, but integral to shifting the weight between our entire upper body and our legs. The sacroiliac joints are held tightly together by ligaments and are supported by pelvic muscles. Like any joint, these ligaments and muscles can be strained and become tight. Issues like this sometimes require physical therapy, stretching, and other pain management techniques such as cortisone injections. A women’s sacroiliac joints are looser to permit childbirth, and therefore more susceptible to instability and other issues that could cause hip or lower back pain.
Our main hip joints are formed by the round head located at the top of our femur, or thigh bone, and the acetabulum, which is the socket located in the pelvic bone. The actual hip joint is located at the lower portion of our pelvic bones, where the round femur bone meets (or articulates) with the cup shaped acetabulum. It is this joint which allows us to sit, walk, or run. More specifically, this ball and socket joint gives us the freedom to perform movements such as abduction (raising our legs toward the outer side of our bodies), adduction (lowering our legs), flexion (bending our legs at the knee), extension (straightening our legs), and rotation.
The rounded head of the femur and the acetabulum are both lined with a 3 to 5 mm (1/4 inch) layer of articular cartilage. Articular cartilage is a white, rubbery, smooth tissue that lines the joint so that the bones can glide over each other easily during movement. During osteoarthritis, the articular cartilage becomes worn down and can even break off to form loose bodies in the joint, possible bone damage, and other painful symptoms. Once the cartilage has worn away, the damaged hip joint can cause multiple secondary symptoms such as pain, swelling, stiffness, limping, difficulty putting shoes and socks on, challenges with stairs and getting in and out of cars, and even sexual activity.
The rim of our acetabulum is also lined with a special cartilage called the labrum. This is a tough tissue that seals the ball-head of the femur firmly into the acetabulum. It is the main structure holding the joint together, though our ligaments and muscles also support the joint. This labrum can be torn or damaged easily during sports injuries or other trauma injuries. A torn labrum cannot hold the hip joint together securely and causes instability in the joint. Without treatment, this can cause pain, gait abnormalities, loose bodies in the joint, and lead to other severe hip conditions.
The ligaments that support our hip joints also surround it in a sealed joint capsule. Synovial fluid fills this capsule, providing further lubrication for frictionless movement between the bones and tissues. The joint capsule surrounding our hip joints is especially strong and dense because these weight-bearing joints require extra stability.
Within the hip joint capsule there is one small ligament known as the ligament of the head of the femur. It runs between the head of the femur and the interior acetabulum, housing the obturator artery, which provides some of the blood supply to our hip joints.
Three extracapsular ligaments serve as an outer layer of support for our hip joints, and make up the capsule that contains the bones of the hip joint.
The iliofemoral ligament is the strongest ligament in the body. It has a “Y’ shape that connects the sacroiliac region of our spine to the femoral head. This helps keep the femoral head locked into the acetabulum, preventing our hip from hyperextending when we stand. The outer portion of the circumflex artery which provides blood to the femoral head runs through this ligament, so damage to the tissue could lead to necrosis. Necrosis is the loss of blood supply to the tissues of a certain area of the body, leading to the cell’s death.
The ischiofemoral ligament is a spiraling band of tissue that also holds the ball and socket joint together by connecting the neck of the femur (below the rounded head) to the posterior rim of the acetabulum.
The pubofemoral ligament connects the pubic bone to the joint capsule, preventing us from overextending our hip during abduction.