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.
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Osteoarthritis of the Hip
Osteoarthritis, also called degenerative joint disease, is the most common form of arthritis. It occurs most often in the elderly.
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Inflammatory Arthritis of the Hip
The inflammation of the joints is referred to as arthritis. Inflammation arises when the smooth lining called cartilage at the ends of bones wears away.
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Hip Injury
The hip joint is one of the most important and flexible joints in the human body which allows us to walk, run, bend and perform physical activities.
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Hip Instability
Injury or damage to these structures can lead to a condition called hip instability when the joint becomes unstable.
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Hip Dislocation
The hip joint is a “ball and socket” joint. The “ball” is the head of the femur or thighbone, and the “socket” is the cup-shaped acetabulum.
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Hip Labral Tear
A hip labral tear is an injury to the labrum, the cartilage that surrounds the outside rim of your hip joint socket.
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Femoroacetabular Impingement
Femoroacetabular impingement (FAI) is a condition characterized by excessive friction in the hip joint from the presence of bony irregularities.
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Fractures of the Hip in the Elderly
A fracture of the hip in an elderly patient can be a life-threatening illness. Medical complications can arise when elderly patients are confined to bed due to hip fractures.
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Stress Fractures of the Hip
Stress fractures of the hip are more common in athletes, especially distance runners. There are two types of stress fractures. Insufficiency fractures are breaks in abnormal bone under normal force.
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Pelvic Fractures
A pelvic fracture is a condition that occurs due to the breakage of the pelvic bone. It may cause damage to the internal organs, nerves and blood vessels associated with the pelvic region.
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Hip Ligament Injuries
Injuries to the hip ligaments are commonly called a hip sprain and can range from minor tears of the ligaments to more serious injuries involving the hip muscles, tendons or bone.
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Gluteus Medius Tear
A gluteus medius tear is the partial or complete rupture of the gluteus medius muscle due to severe muscle strain.
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Hip Bursitis
Hip bursitis is a painful condition caused by the inflammation of a bursa in the hip. Bursae are fluid-filled sacs present in the joints between bone and soft tissue to reduce friction and provide cushioning during movement.
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Hip Osteonecrosis
Hip osteonecrosis occurs due to disruption of the blood supply to the highest part of the thigh bone (femoral head). Due to lack of nourishment, the bone tissue of the femoral head dies and gradually collapses.
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Avulsion Fractures of the Pelvis
Avulsion fractures of the pelvis is an injury that occurs when a tendon or ligament pulls off a piece of bone from the hip.
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Pediatric Femur Fracture
The femur or thighbone is the largest and strongest bone in the human body. Pediatric thighbone fractures can occur when your child falls hard on the ground and gets hit during sports, automobile accidents and child abuse.
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Femoral Shaft Fracture
A femoral shaft fracture is a crack or break anywhere along the long and straight section of the femur (thighbone) due to high-energy trauma or low-energy trauma in osteoporotic patients.
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Hip Arthritis
There are many conditions that can result in degeneration of the hip joint. Osteoarthritis is perhaps the most common reason that patients need to undergo hip replacement surgery.
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Hip Fracture
The hip joint is a “ball and socket” joint. The “ball” is the head of the femur or thighbone, and the “socket” is the cup-shaped acetabulum.
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Femur Fracture
he femur or thigh bone is the longest and strongest bone in the body, connecting the hip to the knee. A femur fracture is a break in the femur.
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Hamstring Injuries
Hamstring is the common name for the big group of muscles and tendons in the back of your thigh. These powerful muscles are often injured, especially by athletes.
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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.
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Avascular Necrosis
Bones are living tissue relying on blood vessels to bring blood to keep them alive. Most living tissues have blood vessels that come from many directions into the tissue.
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Trochanteric Bursitis of the Hip
In many areas of the body, muscles and tendons must slide over and against one another during movement. At each of these places, a small sac of lubricating fluid helps the muscles and tendons move properly.
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Developmental Dysplasia
Developmental dysplasia of the hip (DDH) or hip dysplasia is a condition that is seen in infants and young children because of developmental problems in the hip.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
