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.
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Conditions
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,
Transient Osteoporosis of the Hip
Transient osteoporosis of the hip is a rare condition that causes bone loss temporarily in the upper part of the thighbone (femur). It is mostly found in young or middle aged men between the ages of 30 and 60, and women in their later stages of pregnancy or early postpartum period (following childbirth). It is characterized by abrupt onset of pain that increases with activity.
Snapping Hip
The hip is an important joint that helps us walk, run and jump. The ball-and-socket joint in the hip is formed between the round end of the femur (thighbone) and the cup-shaped socket of the acetabulum (part of the hip bone). Joint stability in the hip region is achieved through the labrum (a strong fibrous cartilage), which covers the acetabulum and seals it, and ligaments (tissue connecting bone to bone) and tendons (tissue connecting muscle to bone) that encase the hip and control the hip movements.
Muscle Strain
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. The most common symptom of hip strain is pain and swelling in the area of injury. Pain may worsen on using the injured muscle and also the strength in the muscle may also decrease.
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.
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 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).
Gluteus Medius Tear
A gluteus medius tear is a condition characterized by severe strain on the gluteus medius muscle that results in partial or complete rupture of the muscle.
Hip Labral Tear
A hip labral tear is an injury to the labrum, the cartilage that surrounds the outside rim of your hip joint socket. The hip joint is a ball and socket joint in which the head of the femur is the ball and the pelvic acetabulum forms the socket. The labrum helps to deepen the socket and provide stability to the joint. It also acts as a cushion and enables smooth movements of the joint.
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. Injury or damage to these structures can lead to a condition called hip instability. Hip instability happens when the hip joint becomes unstable causing various symptoms.
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. Other causes include fractures, trauma, bone and cartilage inflammation, and benign tumors of the synovial membrane.
Snapping Hip Syndrome
The hip is an important joint that helps us walk, run and jump. The ball-and-socket joint in the hip is formed between the round end of the femur (thighbone) and the cup-shaped socket of the acetabulum (part of the hip bone). Joint stability in the hip region is achieved through the labrum (a strong fibrous cartilage), which covers the acetabulum and seals it, and ligaments (tissue connecting bone to bone) and tendons (tissue connecting muscle to bone) that encase the hip and control the hip movements.
Hip Groin Disorders
Hip and groin disorders are more common in athletes, caused by rapid acceleration and deceleration motion. The rehabilitation time for hip and groin injuries are longer than most of the other injuries, therefore early and accurate diagnosis is essential. The management of the hip and groin injuries is complex due to the presence of multiple anatomic structures in that region. Moreover, the signs and symptoms of most of the hip and groin disorders are similar making the diagnosis difficult.
Hip Distraction
The hip joint is one of the most important and flexible joints in the human body which allows us to walk, run, bend and perform physical activities. It is a ball (femoral head) and socket joint formed between the hip bone and femur (thigh bone). The hip joint is surrounded by strong muscles and tough ligaments that prevent dislocation of the hip. The hip joint allows a greater range of motion of your body and hence is subjected to wear and tear. If the hip joint breaks or dislocates during an accident or due to old age, it may affect the blood supply to the bone, a condition called avascular necrosis (characterized by loss of blood to the bone). Avascular necrosis is generally treated by hip distraction arthroplasty, a surgical procedure which decreases the pain in the hip joint and increases the ability to perform daily activities.
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 Abductor Tears
Hip abductors are a major group of muscles found in the buttocks. It includes the gluteus maximus, gluteus medius, gluteus minimus, and tensor fascia lata muscles.
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.
Developmental Dysplasia
Developmental dysplasia of the hip (DDH) or Hip dysplasia is a condition which is seen in infants and young children as a result of developmental problems in the hip joint. The femur (thigh bone) partially or completely slips out of the hip socket causing dislocation at the hip joint. It is most common in first born baby with family history of the disorder. The exact cause for hip dysplasia is not known. Genetic factors play an important role in causing this birth defect. DDH can be mild or severe and can affect one or both hips. It is more common in girls and usually affects the left hip. DDH does not cause any pain and so the condition may not be noticed until the child starts to walk.
Legg-Calve-Perthes Disease
Legg-Calve-Perthes Disease (LCPD) or Perthes disease is a disorder of the hip that affects children, usually between the ages of 4 and 10. It usually involves one hip, although it can occur on both sides in some children. It occurs more commonly in boys than girls.
Slipped Capital Femoral Epiphysis
Slipped capital femoral epiphysis (SCFE) is an unusual disorder of the hip where the ball at the upper end of the thigh bone (femur) slips in a backward direction. This is caused due to weakness of the growth plate. This condition is commonly caused during accelerated growth periods such as the onset of puberty.
Irritable Hip
Irritable hip, also known as acute transient synovitis, is a common disorder of childhood characterized by onset of hip pain and limping. The term transient means that it does not usually last long. It usually occurs before puberty and affects only one hip. Boys aged between 4 to 10 years are most often affected 2 to 4 times more than girls.
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.
Hip Pointers
The hip joint consists of 2 bones, the hip bone and the leg bone. An injury or bruise to one of these bones or the surrounding muscles or tissues is termed a hip pointer. This type of injury is mainly caused due to a sudden blow or hit on the hip which can occur from sports activities such as football, rugby, volleyball, basketball, cycling or skating.
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.
Procedures
Non-surgical
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, 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. It thus serves a diagnostic function and helps to confirm or deny whether the joint is the source of pain. Cortisone serves to reduce the inflammation in the joint providing long term pain benefit.
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.
Platelet-Rich Plasma Injection
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.
Shock Wave Therapy
Extracorporeal Shock Wave Therapy (ESWT) is a non-invasive (no cutting of skin and no introduction of any medical device in the body) method of treating soft tissue injuries. Extracorporeal means outside the body. Shock wave is a short energy wave with high intensity, traveling faster than sound. ESWT does not disintegrate tissue; rather it causes biological effects that help in tissue regeneration. ESWT reduces pain and sensitivity immediately by over-stimulating pain transmission nerves. It triggers the repair mechanism of the body by formation of new blood vessels. The shock wave stimulates osteoblasts (bone cells) in the body and promotes bone healing and new bone production.
Replacement
Total Hip Replacement
Total hip replacement is a surgical procedure in which the damaged cartilage and bone is removed from the hip joint and replaced with artificial components. The hip joint is one of the body's largest weight-bearing joints, located between the thigh bone (femur) and the pelvis (acetabulum). 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 which acts as a cushion and enables smooth movements of the joint.
Revision Hip Replacement
Revision hip replacement surgery is performed under general anesthesia. During the procedure, your surgeon will make an incision over the hip to expose the hip joint. Then the femur is dislocated from the acetabulum so that the old plastic liner and the metal socket can be removed from the acetabulum.
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.
Direct Superior Total Hip Replacement
The Direct Superior Approach (DSA) is a minimally invasive approach used in total hip replacement surgery. This muscle sparing approach for total hip replacement was developed to minimize damage to the soft tissues and muscles that are critical to the proper function of your hip and leg.1 The Direct Superior Approach was developed to allow the surgeon to avoid cutting key muscle groups, the most important being the Iliotibial (IT) band and muscles referred to as external rotators.1
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.
Posterior Hip Replacement
Posterior hip replacement is the most common approach to total hip replacement used by surgeons across the world. A mini-posterior approach provides the same advantages of the traditional approach with regards to position of the incision which is close to the buttock (on the posterior side). This is the easiest approach providing the surgeon ease of exposure of both the femur and the hip socket thereby minimizing the risk of femoral fracture and improper positioning of the implant. Posterior approach also minimizes the risk of nerve injury.
Other Surgeries
Hip Implants
Coming Soon
Minimally Invasive Supra Capsular
Coming Soon
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.
After Hip Replacement
Hip replacement is a surgery performed to replace parts of a diseased hip joint with prosthesis. The goal of hip replacement is to eliminate pain and return you to your normal activities. You can help in recovery and improve the outcomes of the procedure by following certain precautions and changing the way you carry out your daily activities.
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 Fracture Surgery
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.