Anthony J. Berni, MD Orthopedic Surgeon

Anthony J. Berni, MD Orthopedic Surgeon

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Hip

Hip Anatomy

The thigh bone, femur, and the pelvis, acetabulum, join to form the hip joint. The hip joint is a “ball and socket” joint. The “ball” is the head of the femur, or thigh bone, and the “socket” is the cup shaped acetabulum.The joint surface is covered by a smooth articular surface that allows pain free movement in the joint.

Muscle Strain (Hip)

A tear in the muscle fibers caused by either a fall or direct blow to the muscle, overstretching and overuse injury is called a strain. Muscle strains often occur in the hip region whenever a muscle contracts all of a sudden from its stretched position. It can be mild, moderate or severe and depends on the level of injury. The chances of having a hip muscle strain becomes high if you have had a previous injury in the area or if there is no warm-up before exercising.

Hip Bursitis

Hip bursitis is a painful condition caused by inflammation of a bursa in the hip. Bursae are fluid filled sacs present in joints between bone and soft tissue to reduce friction and provide cushioning during movement.The bony prominence of the hip is called greater trochanter and is present on the outer side of the upper thigh bone or femur.

Femoroacetabular Impingement (FAI)

Femoroacetabular impingement (FAI) is a condition where there is too much friction in the hip joint from bony irregularities causing pain and decreased range of hip motion. The femoral head and acetabulum rub against each other creating damage and pain to the hip joint. The damage can occur to the articular cartilage (the smooth white surface of the ball or socket) or the labral tissue (the lining of the edge of the socket) during normal movement of the hip. The articular cartilage or labral tissue can fray or tear after repeated friction.

Avascular Necrosis

Avascular necrosis, also called osteonecrosis is a condition in which bone death occurs because of inadequate blood supply to it. Lack of blood flow may occur when there is a fracture in the bone or a joint dislocation that may damage nearby blood vessels. Chronic use of high doses of steroid medications and heavy alcohol consumption are the two main risk factors of avascular necrosis. Initially, small breaks appear in the bone that may eventually collapse. Hip joint is most commonly affected; however, the knee and shoulder may also be involved.

Hip Fracture

The hip joint is a “ball and socket” joint. The “ball” is the head of the femur, or thigh bone, and the “socket” is the cup shaped acetabulum. The joint surface is covered by a smooth articular surface that allows pain free movement in the joint.Hip fracture is 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.

Hip Dislocation

The hip joint is a ball and socket joint. The “ball” is the head of the femur, or thigh bone, and the “socket” is the cup shaped acetabulum. The joint is surrounded by muscles, ligaments, and tendons that support and hold the bones of the joint in place. Hip dislocation occurs when the head of the femur moves out of the socket. The femoral head can dislocate either backward (posterior dislocation) or forward (anterior dislocation).

Chondral Lesions or Injuries

The hip joint is one of the largest weight-bearing joints in the body, formed by the thigh bone or femur and the acetabulum of the pelvis. It is a ball and socket joint with the head of the femur as the ball and the pelvic acetabulum forming the socket. The joint surface is covered by a smooth articular cartilage which acts as a cushion and enables smooth movements of the joint. A chondral injury refers to an injury of the articular cartilage, covering the joint.

Hip Instability

The hip plays an important role in supporting the upper body weight while standing, walking and running, and hip stability is crucial for these functions. The femur (thigh bone) and acetabulum (hip bone) join to form the hip joint, while the labrum (tissue rim that seals the hip joint) and the ligaments lining the hip capsule maintain the stability of the hip.

Loose Bodies

Loose bodies are small loose fragments of cartilage or a bone that float around the joint. The loose bodies can cause pain, swelling, locking and catching of the joint. Loose bodies occur if there is bleeding within the joint, death of tissues lining the joints associated with tuberculosis, osteoarthritis, and rheumatoid arthritis.

Hip Pain

Hip pain, one of the common symptoms patients complain of, may not always be felt precisely over the hip joint. Pain may be felt in and around the hip joint and the cause for pain is multifactorial. The exact position of your hip pain suggests the probable cause or underlying condition causing pain. Pain felt inside the hip joint or your groin area is more likely to be because of the problems within the hip joint. Likewise, the pain felt on the outer side of your hip, upper thigh or buttocks may be a result of the problems of the muscles, ligaments, tendons and soft tissues surrounding the hip joint.

Subtrochanteric Hip Fracture

A hip fracture is 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. The lesser trochanter projects from the base of the femoral neck on the back of the thigh bone. Hip fractures can occur either due to a break in the femoral neck, in the area between the greater and lesser trochanter or below the lesser trochanter.

Hip Synovitis

Hip synovitis, also called transient hip synovitis or toxic synovitis is a condition in which there is inflammation of the synovial tissues surrounding the hip joint causing hip pain. It is the most common reason for sudden hip pain occurring in young children between the age of 2 and 9. It affects boys more commonly than girls and most of the times, the hip joint on only one side is affected.

Hip Tendonitis

Tendons are strong connective tissue structures that connect muscle to bone. Hip tendonitis is a condition associated with degeneration of the hip tendons. This condition is mainly caused due to strain on the tendons which may be due to overuse, or biomechanical problems.

Osteoarthritis of The Hip

Osteoarthritis, also called degenerative joint disease is the most common form of arthritis. It occurs most often in older people. This disease affects the tissue covering the ends of bones in a joint (cartilage). In a person with osteoarthritis, the cartilage becomes damaged and worn out causing pain, swelling, stiffness and restricted movement in the affected joint. Although osteoarthritis may affect various joints including hips, knees, hands, and spine, hip joint is most commonly affected. Rarely, the disease may affect the shoulders, wrists and feet.

Inflammatory Arthritis of The Hip

Inflammation of the joints is referred to as arthritis. The inflammation arises when the smooth covering (cartilage) at the end surfaces of the bones wears away. In some cases, the inflammation is caused when the lining of the joint becomes inflamed as part of an underlying systemic disease. These conditions are referred to as inflammatory arthritis.

Hip Injections

Hip joint injections involve injecting medicine directly into the hip joint to diagnose the source of pain or treat pain due to conditions such as arthritis, injury or mechanical stress of the hip joint. Hip pain may be experienced in the hip, buttock, knee, leg or low back. The injection contains a combination of a numbing medicine and cortisone (an anti-inflammatory agent). Numbing medicine delivers temporary relief from pain, provided the hip joint is the source of the pain.

Physiotherapy

Physiotherapy is one of the treatment modalities to treat orthopedic conditions where specially designed exercises and equipments help patients restore their normal physical activities. Physiotherapy is advised when the health problems make it hard to move around and make your daily activities uneasy.

Shock Wave Therapy

Platelet Rich Plasma Therapy or PRP is an emerging treatment in health care to rejuvenate your skin by stimulating collagen, the main component of connective tissue. The therapy improves lines, wrinkles and texture with a gradual natural change. The therapy is also helpful for treating skin conditions and for general skin reconditioning. The most dramatic results so far have been seen with improvement of crepe skin problems in areas such as the neck, under the eyes and décolletage areas.

Revision Hip Replacement

Revision hip replacement is a complex surgical procedure in which all or part of a previously implanted hip-joint is replaced with a new artificial hip-joint. Total hip replacement surgery is an option to relieve severe arthritis pain that limits your daily activities. During total hip replacement, the damaged cartilage and bone is removed from the hip joint and replaced with artificial components. At times, hip replacement implants can wear out for various reasons and may need to be replaced with the help of a surgical procedure known as revision hip replacement surgery.

Minimally Invasive Total Hip Replacement

The hip joint is one of the body's largest weight-bearing joints and is the point where the thigh bone (femur) and the pelvis (acetabulum) join. It is a ball and socket joint in which the head of the femur is the ball and the pelvic acetabulum forms the socket. The joint surface is covered by a smooth articular cartilage that cushions and enables smooth movements of the joint.

Outpatient Hip Replacement

Hip replacement surgery is the most common orthopedic surgery performed. It involves the replacement of the damaged hip bone (ball shaped upper end of the femur) with a metal ball attached to a metal stem that is fixed into the femur and attached to the pelvic region. Traditionally, the surgery was performed with a large, open incision and required the patient to stay in the hospital for several days. With advanced techniques, it is now possible to perform these surgeries on an outpatient basis where the patient goes home on the same day.

Hip Repair

Labrum is a ring of strong fibrocartilaginous tissue lining around the socket of the hip joint. Labrum serves many functions where it acts as shock absorber, lubricates the joint, and distributes the pressure equally. It holds the head of the femur in place and prevents the lateral and vertical movement of the femur head with in the joint. It also deepens the acetabular cavity and offers stability against femoral head translation.

Core Decompression for Avascular Necrosis of The Hip

The hip joint is a ball and socket joint, where the head of the thigh bone (femur) articulates with the cavity (acetabulum) of the pelvic bone.Sickle cell disease, a group of disorders that affect the hemoglobin or oxygen carrying component of blood, causes avascular necrosis or the death of bone tissue in the hip due to lack of blood supply.

Hip Hemiarthroplasty

The hip joint is one of the body's largest weight-bearing joints and is the point where the thigh bone (femur) and the pelvis (acetabulum) unite. It is a ball and socket joint in which the head of the femur is the ball and the pelvic acetabulum forms the socket. The joint surface is covered by a smooth articular cartilage that cushions and enables smooth movements of the joint.

Pre-op & Post-op Hip Guidelines

Planning for your hip surgery prepares you for the operation and helps to ensure a smooth surgery and easier recovery. Here are certain pre-operative and post-operative guidelines which will help you prepare for hip surgery.

Caregivers Guide for The Hip

When your friend or loved one has undergone a hip replacement surgery, as a caregiver, you will play an important role in his/her recovery. There are various aspects you need to be aware of to ensure the safety, comfort and recovery of the patient. Some of these include:

Hip Fracture Prevention

Hip fractures refer to any kind of breakage or damage in the thigh bone (femur). People over the age of 65, especially women, are highly vulnerable to hip fractures. You will require assistance after hip fractures from family members as well as health professionals and may also be required to be admitted to the hospital for further assistance. Hip fractures can be caused due to weak bones (osteoporosis) or from a fall. Osteoporosis is due to various factors such as age, gender, nutrition, life style or heredity.

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  • J Berni MD Orthopedic Surgeon American Acaadmey Of Orthopaedic Surgeon
  • American board Of Orthopaedic Surgery
  • J Berni MD Orthopedic Surgeon Saint Louis University
  • J Berni MD Orthopedic Surgeon University Of Missouri-Health
  • J Berni MD Orthopedic Surgeon St Charles Orthopadeic Surgery Associate