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Whether you’re sitting, standing, walking, or bending, your hips are a fundamental component of your daily life. Connecting the thighbone to the trunk, the hip consists of a cup-and-ball-like joint that allows for a great deal of motion in a variety of directions. People of varying ages and lifestyles are susceptible to dozens of different hip conditions and diseases, including osteoarthritis and bursitis. To read more about hip conditions, click here.

At OrthoNorCal Orthopedic Specialists, our hip surgeons have sophisticated training and experience in performing highly specialized hip procedures. Common procedures our hip surgeons perform include total hip replacement, hip revision, total hip arthroplasty, anterior hip replacement, hip impingement surgery, hip labral repair, and hip fracture treatment. Please note that our hip surgeons are proficient in using the latest surgical methods, including minimally invasive techniques.

  • Hip Arthroscopy

    Hip arthroscopy, also referred to as keyhole or minimally invasive surgery, is a procedure in which an arthroscope is inserted into your hip joint to check for any damage and repair it simultaneously.

  • Total Hip Replacement

    Total hip replacement surgery is an elective procedure. Along with your doctor, you will decide when the time is right for this surgery.

  • Stem Cell Therapy for Hip Injuries

    Stem cell therapy is a form of regenerative medicine that utilizes the body’s natural healing mechanism to treat various conditions.

  • Revision Hip Replacement

    Hip revisions are much more complex surgeries than primary (or first time) hip replacements because of the removal of the primary implant, previous scarring, loss of bone, and/or possible infection.

  • Posterior Hip Replacement

    Posterior hip replacement is a minimally invasive hip surgery performed to replace the hip joint. It is also referred to as muscle sparing surgery because no muscles are cut to access the hip joint, enabling a quicker return to normal activity.

  • Outpatient Hip Replacement

    Hip replacement surgery is one of the most common orthopedic surgeries performed. It involves the replacement of the damaged hip bone with a ceramic ball attached to a metal stem that is fixed into the femur and placing a new cup with a special liner in the pelvis.

  • Minimally Invasive Total Hip Replacement

    Traditional hip replacement surgery is performed by making a 12-18-inch incision in the patient’s thighbone. The incision allows the doctor to remove the diseased hip joint and replace it with an implant.

  • Hip Fracture Surgery

    Hip fractures involve a break that occurs near the hip in the upper part of the femur or thigh bone. The thigh bone has two bony processes on the upper part - the greater and lesser trochanters.

  • Outpatient Anterior Approach Hip Replacement

    It is a minimally invasive procedure that has been developed to cause less muscle damage, faster recovery, and less disruption in a patient’s life.

  • Periacetabular Osteotomy

    Periacetabular osteotomy is a surgical procedure to treat a congenital hip condition called hip dysplasia. Hip dysplasia is either present from birth or develops in the first few months of life.

  • Anterior Approach to Total Hip Replacement

    The Anterior Approach is an alternative to conventional hip replacement surgery. This technique approaches the hip joint from the front as opposed to the side or back.

  • Hip Fracture ORIF

    A hip fracture is a break that occurs near the hip in the upper part of the femur or thighbone. The thighbone has two bony processes on the upper part - the greater and lesser trochanters.

  • Robotic Assisted Hip Surgery

    Robotic assisted hip surgery is a minimally invasive surgical procedure that involves the use of a specialized robotic system to remove the damaged parts of a hip joint and replace them with an artificial prosthesis or implant.

  • Compression Fixation for a Fractured Hip

    Compression hip screw fixation can be an involved surgery with several fragments of bone needing to be held together. There may also be substantial blood loss during surgery.

  • Physical Therapy for Hip

    Physical therapy is an exercise program that helps you to improve movement, relieve pain, encourage blood flow for faster healing, and restore your physical function and fitness level.

  • Physical Examination of the Hip

    The physical examination of the hip by your doctor includes a visual inspection of your hip, palpation of the hip to diagnose tenderness or any abnormality, etc; and testing range of motion of the hip.

Hip Joint

The hip joint is the largest weight-bearing joint in the human body. It is also referred to as a ball and socket joint and is surrounded by muscles, ligaments, and tendons. The thigh bone or femur and the pelvis join to form the hip joint.

Any injury or disease of the hip will adversely affect the joint's range of motion and ability to bear weight.

The hip joint is made up of the following:

  • Bones and joints
  • Ligaments of the joint capsule
  • Muscles and tendons
  • Nerves and blood vessels that supply the bones and muscles of the hip

Bones and Joints

The hip joint is the junction where the hip joins the leg to the trunk of the body. It is comprised of two bones: the thigh bone or femur and the pelvis which is made up of three bones called ilium, ischium, and pubis. The ball of the hip joint is made by the femoral head while the socket is formed by the acetabulum. The Acetabulum is a deep, circular socket formed on the outer edge of the pelvis by the union of three bones: ilium, ischium, and pubis. The lower part of the ilium is attached by the pubis while the ischium is considerably behind the pubis. The stability of the hip is provided by the joint capsule or acetabulum and the muscles and ligaments which surround and support the hip joint.

The head of the femur rotates and glides within the acetabulum. A fibrocartilagenous lining called the labrum is attached to the acetabulum and further increases the depth of the socket.

The femur or thigh bone is one of the longest bones in the human body. The upper part of the thigh bone consists of the femoral head, femoral neck, and greater and lesser trochanters. The head of the femur joins the pelvis (acetabulum) to form the hip joint. Next, to the femoral neck, there are two protrusions known as greater and lesser trochanters which serve as sites of muscle attachment.

Articular cartilage is the thin, tough, flexible, and slippery surface lubricated by synovial fluid that covers the weight-bearing bones of the body. It enables smooth movements of the bones and reduces friction.

Ligaments

Ligaments are fibrous structures that connect bones to other bones. The hip joint is encircled with ligaments to provide stability to the hip by forming a dense and fibrous structure around the joint capsule. The ligaments adjoining the hip joint include:

  • Iliofemoral ligament: This is a Y-shaped ligament that connects the pelvis to the femoral head at the front of the joint. It helps in limiting the over-extension of the hip.
  • Pubofemoral ligament: This is a triangular shaped ligament that extends between the upper portion of the pubis and the iliofemoral ligament. It attaches the pubis to the femoral head.
  • Ischiofemoral ligament: This is a group of strong fibers that arise from the ischium behind the acetabulum and merge with the fibers of the joint capsule.
  • Ligamentum teres: This is a small ligament that extends from the tip of the femoral head to the acetabulum. Although it has no role in hip movement, it does have a small artery within that supplies blood to a part of the femoral head.
  • Acetabular labrum: The labrum is a fibrous cartilage ring which lines the acetabular socket. It deepens the cavity, increasing the stability and strength of the hip joint.

Muscles and Tendons

A long tendon called the iliotibial band runs along the femur from the hip to the knee and serves as an attachment site for several hip muscles including the following:

  • Gluteals: These are the muscles that form the buttocks. There are three muscles (gluteus minimus, gluteus maximus, and gluteus medius) that attach to the back of the pelvis and insert into the greater trochanter of the femur.
  • Adductors: These muscles are located in the thigh which helps in adduction, the action of pulling the leg back towards the midline.
  • Iliopsoas: This muscle is located in front of the hip joint and provides flexion. It is a deep muscle that originates from the lower back and pelvis and extends up to the inside surface of the upper part of the femur.
  • Rectus femoris: This is the largest band of muscles located in front of the thigh. They also are hip flexors.
  • Hamstring muscles: These begin at the bottom of the pelvis and run down the back of the thigh. Because they cross the back of the hip joint, they help in extension of the hip by pulling it backward.

Nerves and Arteries

Nerves of the hip transfer signals from the brain to the muscles to aid in hip movement. They also carry the sensory signals such as touch, pain, and temperature back to the brain.

The main nerves in the hip region include the femoral nerve in the front of the femur and the sciatic nerve at the back. The hip is also supplied by a smaller nerve known as the obturator nerve.

In addition to these nerves, there are blood vessels that supply blood to the lower limbs. The femoral artery, one of the largest arteries in the body, arises deep in the pelvis and can be felt in front of the upper thigh.

Hip Movements

All of the anatomical parts of the hip work together to enable various hip movements. Hip movements include flexion, extension, abduction, adduction, circumduction, and hip rotation.

  • American Orthopaedic Society for Sports Medicine
  • American Association for Hand Surgery
  • American Academy Of Orthopaedic Surgeons
  • The American Board of Pediatrics
  • North American Spine Society
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