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About
Orthpaedic Surgery
Hip
Anatomy
| Hip Fracture | Arthritis
| Total Hip Replacement
Anatomy
The hip is a ball and socket joint, with the socket (acetabulum)
in the pelvis meeting the ball (femoral head) located on the upper
end of the thigh bone (femur). It is a very stable joint because
of the deep socket which limits hip motion. The most common clinical
conditions involving the hip include osteo- or rheumatoid arthritis,
fracture, or dislocation. Top
Hip Fracture
Fracture of the hip is a common injury in the elderly patient after
a fall,
due to the weakening of bone which occurs with aging. The fracture
can
be in the femoral neck or in the trochanteric area. Where the fracture
occurs, the degree of displacement, the number of fractures, and
the age
of the patient are all considered in determining the type of treatment
needed, which is almost always surgical.
Undisplaced
and minimally displaced fractures of the femoral neck are
usually treated with pins or screws placed across the fracture.
Displaced
femoral neck fractures, particularly in those who are advanced in
age, are
often treated with removal of the femoral head and neck and insertion
of a
femoral hip prosthesis, similar to a total hip femoral component,
into the
canal inside the upper femur, which allows early walking with weight
bearing. Fractures of the trochanteric area are treated with screws
inside
the femoral neck which are connected to a plate or rod to stabilize
the
fractures until they heal.
Complications
following hip fractures are primarily those seen in elderly
patients following any major surgery: phlebitis, pneumonia, infection,
and
post-operative confusion. Top
Arthritis
of the Hip
The two most commonly occurring types of arthritis are osteoarthritis
and rheumatoid arthritis. Both can be progressive diseases, which
cause degeneration of the joint cartilage and painful roughening
and deformity of the joint surfaces. Both may ultimately require
total hip replacement, although some osteoarthritic
hips can be treated by osteotomy, or bony realignment.
Diagnosis is
based on pain, decreased motion, weakness of the hip muscles, and
x-ray evidence of narrowing and deformity of the joint. Treatment
may include exercises to strengthen the hip muscles, anti-inflammatory
medications, and a cane to be used in the hand opposite the affected
hip, which decreases the forces across it. Top
Total Hip
Replacement
When a hip is painful enough to interfere with daily activities,
a replacement of the hip and socket can be done. In most total hips
designs, the head and neck of the femur are cut off and replaced
by a metal prosthesis, which is placed inside the femur and fixed
either with cement or with bone ingrowth into a special surface
on the prosthesis. Similarly, the socket, or acetabulum, is enlarged
and a cup with a polyethylene socket liner is fixed to the pelvis
by similar methods. Following appropriate rehabilitation, the hip
moves almost normally and usually allows the patient to walk painlessly
without support.
Although the
results are overwhelmingly satisfactory, hip replacement is a major
surgical procedure with potential complications, such as infections,
medical complications, dislocation of the hip prosthesis, and loosening
of the components, which may require re-operation. Top
NOTE: The information
on this site is informational only and is not intended to be medical
advice. NO ANSWERS TO MEDICAL QUESTIONS WILL BE GIVEN BY E-MAIL
OR OTHER CORRESPONDENCE. Contact your physician for advice about
specific medical conditions.
About
Us | Information for Patients
About
Orthopaedic Surgery | Online
Patient Services
Northern
Rockies Orthopaedics
2831 Fort Missoula Road, Suite 232
Physicians Center #2
Missoula, MT 59804
(406) 728-6101, (800) 823-BONE
FAX: 406-721-3278
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2004-2009 Northern Rockies Orthopaedics, All Rights Reserved
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