Shakira is right, your hips don’t lie,* especially when they are in pain. But with the right help your hips can be shaking for years to come without a hip replacement surgery
*You know, from the 2009 hit “Hips Don’t Lie.”
Hip pain can strike throughout a person’s life and come from a range of causes. When pain hits it is important to look at all of the possible treatment options, especially for those who are younger and active.
My goal, along with my fellow physicians at Muir Orthopaedic Specialists (MOS), is to help patients preserve and extend the life of a natural joint. We offer a comprehensive approach to improve the function of the hip and delay the onset of arthritis. We work with each patient to find the best treatment option that will leave him or her with the least amount of downtime and the most motion.
While I specialize in the surgical part of joint preservation, we have other partners at the practice who focus on nonsurgical injection treatments–and we have a great physical therapy department. No matter what treatment fits your condition, we make a smooth transition to any provider or department you may work with. We are a team, looking out for the best for each patient.
Common causes of early hip problems
It is common that a young adult can suffer from the hip joint abnormalities such as dysplasia or femoroacetabular impingement (FAI). These conditions, if left untreated, can cause future pain and osteoarthritis, often in one’s 30s or 40s. This can lead to the need for surgical replacement or reconstruction of the joint at a young age. If we can diagnose these problems early enough, we can do many things to extend the life of the joint and delay the need for a hip replacement.
Hip dysplasia is a congenital condition in which the hip socket does not fully develop and support the ball of the joint. In severe cases this can cause the hip to dislocate. After birth, the doctor will check for signs of hip dysplasia and if they are present, will place the child in a brace that frequently corrects the issue.
In milder cases of hip dysplasia, symptoms may not be noticeable until the child is a teenager or young adult. Left untreated, it can damage the cartilage lining of the joint and injure the labrum (soft cartilage) that rims the socket portion of the hip joint.
FAI is a deformity of the hip bones and can be categorized into three types: cam, pincer and combined. A cam impingement is caused by an irregular shape of the ball at the top of the femur. A pincer impingement is a prominence or tilting of the front edge of the socket which can rub against the ball of the femur and again damage the labrum and cartilage.
More about an FAI
When to see a doctor
It is time to see an orthopedic specialist for hip pain when you have persistent pain predominantly through the anterior (front of the) hip and groin region that doesn’t go away over a period of a few weeks or months.
Another reason to see a doctor would be if you have stiff hips, even when it is not causing pain. This is most common in young male athletes who do not have a very good range of motion in their hips. They often attribute the limitations in the range of motion to being very muscular, but in fact we know that it frequently is a structural problem related to femoroacetabular impingement. An evaluation can confirm the cause and indicate if treatment is needed before other symptoms develop.
Pre-participation sports physicals are also a good opportunity to check for conditions that could lead to an injury or damage in the hips. At MOS we hold the Pass to Play event to help student athletes each year. During these exams we check joints for range of motion and stability. Frequently we will find unusual bone structures that we can start to treat.
Treatment options to extend the life of your hip joints
Hip joint injections are a great temporary solution to reduce the pain and inflammation of the joint. These are very beneficial in milder cases but can also be very helpful for patients who may need surgery but are unable to have an operation immediately. Injections are completed in the doctor’s office, with the appointment taking around an hour.
We offer corticosteroids, hyaluronic acid and orthobiologic injections. Hyaluronic acid (joint lubricant) injections are not typically done in hips. Orthobiologics are derived from substances such as plasma and bone marrow that naturally occur in the body. These can be used in an injectable form to promote cartilage healing and relieve pain. We offer two types of orthobiologic injections for hip problems, platelet-rich plasma (PRP) and stem cells.
Physical therapy can help improve movement and muscle imbalances that could be leading to hip pain. This treatment option can be used on its own and it is frequently used in combination with injections or after a surgery.
Minimally invasive surgery
At times surgery is needed, but the only option is not a hip replacement. There are minimally invasive surgeries that can aid in increasing movement and extend the life of your natural hip joints.
The most common minimally invasive procedure is a hip arthroscopy. This involves inserting a small camera into the hip joint or surrounding tissue through tiny incisions to guide treatment in the joint. The large benefit of this surgical method versus an open surgery is that you do not need to cut muscle tissue or dislocate the hip for treatment.
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