A worn hip, also called hip osteoarthritis, is a problem with the articular cartilage. Many different aspects play a role in this, including gender, overweight, bone density, the shape of the joint, and participation in different sports.
Causes and Symptoms
Hip wear is often caused by a shape deviation of the head or socket of the hip joint. Such a shape deviation can be small, but in combination with years of stress, the cartilage can wear out and cause osteoarthritis complaints. Also due to a congenital hip defect, overload, trauma, disease, and, for example, rheumatoid arthritis, the cartilage can wear down faster than normal.
When osteoarthritis in the hip occurs, the hip can become stiff and start to hurt. In the beginning, the pain only occurs with intensive activities, but later also with normal daily activities or even at night. The pain is usually located in the groin, sometimes also in the buttocks, and can radiate to the thigh and sometimes also the back. You experience various obstacles in walking, but also flexibility in the hip.
Research and diagnosis
An X-ray is taken of the hip joint to make the diagnosis. The low cartilage of the hip is not immediately visible on an X-ray. Only a dark space is visible between the hip head and hip socket
The orthopedic surgeon recognizes a healthy hip by the smooth and even shape of the cartilage layer in the joint. If this space is narrow or absent, the cartilage is damaged and the hip is worn out. Unfortunately, osteoarthritis of the hip joint is incurable. Non-surgical treatments (hip surgeries) can only relieve pain or delay treatment. For example, we can inject Cortisone into the hip joint with the help of an ultrasound machine. This can keep the pain away for a long time.
People who suffer from hip wear and tear often move differently, they adopt a position where the pain is less palpable. Due to the different ways of moving, muscles can become shorter and stiffer. It is important to move the hip joint as much as possible with as little force as possible.
Physiotherapy (or possibly manual therapy) can help to train the muscles and keep them in shape. Preventing overweight is also important if there is joint wear. Contact sports should also be avoided as they can further damage the hip joint. Anti-inflammatory painkillers can help to relieve the pain just like an injection (which we can perform with the aid of ultrasound), but to permanently remove the complaints, the hip joint will have to be replaced by a hip prosthesis. However, there is only one effective treatment for hip wear and tear and that is a new hip.
The hip prosthesis
Once you have symptoms, they will not go away on their own. Cartilage has no blood vessels or nerves and is, therefore, one of the most difficult issues in the body to repair. Sometimes your complaints can be reduced by moving differently. For example, by adjusting your activities, losing weight, targeted training, and physiotherapy. Painkillers can also reduce the pain somewhat. If these solutions do not help enough or if your complaints increase over time, an artificial hip can bring movement into your life again.
Once the hip wear has passed a certain stage, joint replacement with an artificial hip is the only solution to get rid of the pain and movement problems. Total hip replacement is one of the most commonly performed orthopedic procedures. With an artificial hip, the pain is gone and the mobility is back; a huge improvement in your quality of life
A total hip replacement replaces the socket and head of the hip joint. The socket of a hip prosthesis consists of titanium with a layer of wear-resistant polyethylene or ceramic. The head of the new hip is also made of ceramic. Thanks to modern materials and a good way of fitting, an artificial hip can last up to 20 years.
A labrum is a ring of cartilage that surrounds the socket of the hip joint and makes it deeper. A labrum can break. This is usually due to an accident, sports such as football or water polo, or because the labrum is not strong by itself.
In addition to the bones, cartilage layers, and synovial fluid, the hip joint also consists of a labrum. A labrum is a ring of cartilage that surrounds the socket of the hip joint and makes it deeper. This strengthens the joint.
A labrum can break. This is usually due to an accident, sports such as football or water polo, or because the labrum is not strong by itself. It is also possible that abnormal movement of the hip by a Pincer or Cam (see Impingement in the hip) destroys the labrum.
When the labrum is broken, various problems arise, mainly pain in the groin.
• Groin pain during exercise/exercise
• Groin pain at rest
The first treatment is often exercise or physiotherapy. When the labrum is broken, it will not heal through training. Therefore, despite the therapy, the complaints will exist. Surgical treatment is then a possible outcome. During keyhole surgery in the hip, the broken labrum is examined. There are two treatment options. When the labrum can be sutured, this is done. The labrum is secured (fixed) to the bone with sutures. This allows the labrum to heal again. When this is no longer possible, for example, due to the poor quality of the labrum, the labrum can be removed in its entirety.
Hip impingement has various causes. Two different types are distinguished. The first is an overgrowth of the thigh bone (Femur). The second form is an intergrowth of the pelvis (Pelvis). Due to this deformity, the hip has less mobility, possibly resulting in pain in the hip.
The hip is a ball-and-socket joint, which means that it can move in all directions and can also make a combination of these. For example: straight ahead and to the side. But the joint can also move diagonally upwards. It is possible that due to incorrect bone growth the hip can no longer make the movements that may be expected of a hip joint. Extra bone can grow on the pelvis (Pincer) or extra bone can grow on the neck of the thigh (Cam). This is also known as femoral-acetabular impingement (FAI) syndrome. The CAM probably evolves at the end of growth. This can form an obstacle for daily exercise or during sports, for example. The diagnosis is usually made based on the symptoms and additional imaging diagnostics (X-ray or MRI).
• Groin pain during exercise/exercise
• Groin pain at rest
The first treatment is often exercise or physiotherapy. However, if the accreted bone is the cause of pain in the hip, this will have little or no effect. Surgical treatment is then a possible outcome. During keyhole surgery in the hip, the extra bone that has grown on is removed. As a result, the hip no longer gets stuck at the end of the movement and the pain complaints have usually disappeared.
Bone can decrease in quality or even die for various reasons. We call this bone necrosis or osteonecrosis. This can cause the hip head of the hip joint to collapse. Specific medication use is an important factor in the development of bone necrosis. The suspected cause of bone necrosis is the death of the small blood vessels (capillaries, arterioles) that go to the hip bone. Bone necrosis can cause pain during movement, but also pain at rest. This pain can be felt in the hip, but also the pelvis, groin, buttock, or knee.
Do you want to rule out or have it determined whether you suffer from bone necrosis? Please contact us for more information about this.
Pain in the hip can be caused by an inflamed bursa (bursa). A bursa is a joint that provides smooth guidance of the muscles over the bones. A bursa can cause stabbing pains. This pain is usually on the front or side of the hip and can cause radiating pain down the leg. The bursa can become inflamed due to an accident, this is called traumatic bursitis.
A bursa can also become inflamed from chronic overuse. The bursa swells due to the (acute) overload. This puts him under pressure when making movements with the leg. Lying on the side, for example in bed, is also painful. If you suffer from traumatic bursitis, it is important to rule out the possibility of other damage to your hip. To be sure, please contact us.
Need a quick consultation and treated quickly?
Then make an appointment now!
Make an appointment