The Hip

Information about other hip conditions, including trochanteric bursitis, hip fractures, dislocations, and other injuries.

Hip Bursitis

Hip bursitis is a common problem that causes pain over the outside of the upper thigh. A bursa is a fluid filled sac that allows smooth motion between two uneven surfaces. For example, in the hip, a bursa rests between the bony prominence over the outside of the hip (the greater trochanter) and the firm tendon that passed over this bone. When the bursal sac becomes inflamed, each time the tendon has to move over the bone, pain results. Because patients with hip bursitis move this tendon with each step, hip bursitis symptoms can be quite painful.

Labrum Tear of The Hip Joint

The labrum is a type of cartilage that surrounds the socket of ball-and-socket joints. A labrum is found in both the shoulder and the hip joint. The labrum forms a ring around the edge of the bony socket of the joint. It helps to provide stability to the joint by deepening the socket, yet unlike bone, it also allows flexibility and motion.

Injuries to the labrum have long been recognized as a possible source of pain and discomfort. Labral injuries in the shoulder are much more common, and the treatment of shoulder labral injuries has been more carefully investigated. With the recent development of arthroscopic techniques to surgically manage the hip joint, there has been increased recognition and awareness of hip labral tears.

Iliotibial Band Syndrome

The iliotibial band syndrome is due to inflammation of the iliotibial band, a thick band of fibrous tissue that runs down the outside of the leg. The iliotibial band begins at the hip and extends to the outer side of the shin bone (tibia) just below the knee joint. The band functions in coordination with several of the thigh muscles to provide stability to the outside of the knee joint. Iliotibial band syndrome (ITBS) occurs when there is irritation to this band of fibrous tissue. The irritation usually occurs over the outside of the knee joint, at the lateral epicondyle--the end of the femur (thigh) bone. The iliotibial band crosses bone and muscle at this point; between these structures is a bursa which should facilitate a smooth gliding motion. However, when inflamed, the iliotibial band does not glide easily, and pain associated with movement is the result.

Femoroacetabular Impingement

Femoroacetabular impingement is the condition that occurs when bone spurs form around the hip joint, causing the bone to pinch together when the hip is moved. Bone spurs can form just below the ball of the ball-and-socket hip joint, or just adjacent to the socket.

FAI occurs when the bone spurs pinch together as the hip moves. FAI can cause hip labral tears and may be one of the early signs of hip arthritis. Treatment of FAI can be accomplished with an arthroscopic procedure to shave down the bone spurs, called an osteoplasty.

Hip Osteoarthritis

Osteoarthritis is the most common type of hip arthritis. Also called wear-and-tear arthritis or degenerative joint disease, osteoarthritis is characterized by progressive wearing away of the cartilage of the joint. As the protective cartilage is worn away by hip arthritis, bare bone is exposed within the joint. Hip arthritis typically affects patients over 50 years of age. It is more common in people who are overweight, and weight loss tends to reduce the symptoms associated with hip arthritis. There is also a genetic predisposition of this condition, meaning hip arthritis tends to run in families. Other factors that can contribute to developing hip arthritis include traumatic injuries to the hip and fractures to the bone around the joint.

Hip Dislocation

A hip dislocation occurs when the head of the thighbone (femur) slips out of its socket in the hip bone (pelvis). In approximately 90% of patients, the thighbone is pushed out of its socket in a backwards direction (posterior dislocation). This leaves the hip in a fixed position, bent and twisted in toward the middle of the body. The thighbone can also slip out of its socket in a forward direction (anterior dislocation). If this occurs, the hip will be bent only slightly, and the leg will twist out and away from the middle of the body.

A hip dislocation is very painful. Patients are unable to move the leg and, if there is nerve damage, may not have any feeling in the foot or ankle area.

Hip Arthroplasty

Hip replacement surgery the second most common joint replacement procedure, closely following knee replacements. Many people have hip arthritis, but it can be difficult to know when the right time to have a hip replacement surgery is. Furthermore, there is confusion about what to expect from hip replacement surgery. Do you have questions? Look no further. You can find all you need to know about hip replacement surgery right here.

Hip replacement surgery is performed when the hip joint has reached a point when painful symptoms can no longer be controlled with non-operative treatments. In a hip replacement procedure, your surgeon removes the damaged joint surface and replaces it with an artificial implant.

A total hip replacement is a major surgery, and deciding to have the surgery done is a big decision. Here are some signs to look for to help you decide if the time is right, or not right, for knee replacement surgery.


Manual therapy in osteoarthritis of the hip: outcome
in subgroups of patients