Normally, the hip functions as a “ball-and-socket” joint. The top of the thigh (femur) bone (ball) fits into a part of the pelvis called the acetabulum (socket), allowing the joint to move smoothly in multiple directions. Total hip replacement is a surgical procedure that replaces the hip joint with artificial parts (called prostheses). The most common cause of hip joint deterioration is osteoarthritis; other possible causes include inflammatory arthritis (eg, rheumatoid or psoriatic arthritis), hip disorders of infancy and childhood, osteonecrosis (avascular necrosis), and trauma.
REASONS FOR HIP ARTHROPLASTY
Hip Arthroplasty is only considered when you have tried and failed more conservative treatments, yet you continue to have significant pain, stiffness, or problems with the function of your hip.
Hip Arthroplasty may be performed on adults with a deteriorated hip. However, the replacement parts can break down over time, and healthcare providers generally recommend delaying hip replacement until it is absolutely necessary.
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.
The “hip” is a ball-and-socket joint. It allows the upper leg to bend and rotate at the pelvis. An injury to the socket, or acetabulum, itself is not considered a “hip fracture.” Management of fractures to the socket is a completely different consideration.
Hip fractures most commonly occur from a fall or from a direct blow to the side of the hip. Some medical conditions such as osteoporosis, cancer, or stress injuries can weaken the bone and make the hip more susceptible to breaking. In severe cases, it is possible for the hip to break with the patient merely standing on the leg and twisting.
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).
Hip abductors are a major group of muscles found in the buttocks. They include the gluteus maximus, gluteus medius, gluteus minimus, and tensor fascia lata muscles.
Gluteus medius is situated on the outer surface of the hip. The function of the gluteus medius is to assist with pelvis stability, hip abduction, along with internal and external rotation of the hip. Tears of the gluteus medius usually occur where the tendon inserts at the greater trochanter, causing lateral hip pain.
Tears of the gluteus medius can occur due to traumatic injury or degenerative conditions such as tendinopathy (chronic inflammation of the gluteus medius tendon). Gluteus medius tears cause pain and weakness on the affected side of the hip. One of the main symptoms of a gluteus medius tear is the presence of Trendelenburg sign – dropping of the pelvis towards the unaffected side by being unable to bear weight on the affected limb.
The diagnosis of gluteus medius tear is based on physical examination of the patient, followed by palpation of the affected muscle, testing muscle power and assessing walking pattern or gait of the patient. Certain special tests such as single-leg squat test or a positive Trendelenburg sign confirm the diagnosis of gluteus medius tear. Sometimes, MRI or ultrasound may be helpful to show the pathological changes of the muscle.