The hip joint is classified as a ball-and-socket joint, and comprises the head of the femur (the ball) and the acetabulum (the socket) of the pelvis. Hip pain can indicate a number of different problems. People often mistake hip pain for anything in the pelvic region. On the contrary, hip pain often presents in the groin areas since the hip joint is located near the groin.
Labral Tears
The labrum is a ring of cartilage that surrounds the socket of the hip joint (acetabulum). It provides stability by holding the ball in the socket and provides cushioning for the joint enabling smooth movement. The labrum is usually injured when an external force is applied to a hyperextended, externally rotated hip. Labral tears, in which the cartilage is injured, frequently occur in instances where there is pain, medical or surgical treatment may be required.
Femoral Acetabular Impingement
FAI is an impingement where there is not a perfect fit between the head and socket. There is a small area in the head that has a deformity on it. Hip surgery can help to reduce that deformity, allow a better fit, and reduce pain. Some people are born with FAI, which could possibly lead to a labral tear.
Anytime patients experience hip pain, activity should be modified and a primary care physician or orthopaedic surgeon should be consulted.
Diagnosis
X-rays and an MRI arthrogram are the best choices for a clear diagnosis. Treatment usually consists of surgical intervention to repair the tear.
If your doctors finds that you have a labral tear, a FAI (femoral acetabular impingement), or a cartilage type of lesion such as a loose particle or a defined area of cartilage loss, you may be a candidate for a hip arthroscopy.
Hip Arthroscopy as a Treatment
A hip arthroscopy is a minimally invasive surgical option for patients of any age provided they have a non-arthritic hip. UPMC orthopaedic surgeons perform the surgery by inserting a tiny camera inside the hip at the source of the problem. They use the camera as a guide as they insert other instruments to repair the damaged area.
Our orthopaedic surgeons who perform hip arthroscopies:
- Have trained with the doctors who pioneered hip arthroscopy
- Are among the leaders in their field
- Are bringing advancements and better understanding through research
Due to the minimally invasive nature of a hip arthroscopy the recovery time can be much shorter than an open hip surgery. Another advantage to a minimally invasive option is it may increase the success rate of the surgery, which means there is a less of a chance for revision surgery.
Alternative Treatments
Hip joint pain doesn’t always require hip surgery. Doctors will try other measures, such as activity modification, physical therapy, injections, or anti-inflammatory medication to relieve pain.
Regaining flexibility in the muscle, and normal or improved strength levels, are also required for a safe return to activity.
Prevention
Prevention of labral tears includes maintaining good flexibility and strength around joints.
What are some symptoms of joint pain?
Some common symptoms of joint conditions include:
- Pain in the joint area, especially pain that keeps you awake at night
- Loss of joint function or movement
- Swelling around the joint
Who is a candidate for a hip arthroscopy?
The ideal candidate for this procedure is an active patient of any age who has a defined hip pathology that indicates a labral tear, femoral acetabular impingment (FAI), no hip dysplasia, no arthritis, and no soft tissue tears that could not be fixed arthroscopically.
What conditions can you treat with a hip arthroscopy?
- Labral tear-a tear in the cartilage that lines the hip socket
- FAI an impingement where there is not a perfect fit between the head and socket
- Cartilage type of lesion such as a loose particle or a defined area of cartilage loss
What questions should you ask your doctor?
- What is the diagnosis?
- What does the procedure involve
- What are the risks and complications?
- What are the benefits of having this surgery compared to another?
- How long is the recovery period?
- What is the chance of needing revision surgery?
- What are the published outcomes?