HIP

Treatments &
Procedures

Your hip is the joint where your thigh bone meets your pelvis bone. Hips are called ball-and-socket joints because the ball-like top of your thigh bone moves within a cup-like space in your pelvis. Hips are very stable. When healthy, it takes great force to hurt them. However, playing sports, running, overuse or falling can all sometimes lead to hip injuries. These include strains, bursitis, dislocations and fractures. In older people, osteoarthritis can cause pain and limited motion; osteoporosis of the hip causes weak bones that break easily.

Diagnostic Hip Arthroscopy

Arthroscopic surgery allows diagnosis and treatment of joint problems through small incisions in the skin. A camera attached to a scope is used to see inside your joint.

What is diagnostic hip arthroscopy?

Diagnostic hip arthroscopy is a minimally invasive procedure that allows your orthopedic surgeon to see inside your joint.

What happens during a diagnostic hip arthroscopy procedure?

Your leg is pulled into traction to make more room in the hip joint. Then, an arthroscope—a tube with a tiny camera on the end of it—is inserted in between the ball and socket of your hip joint. The camera projects an image onto a screen for your orthopedic surgeon.

Hip Replacement - Anterior

Anterior hip replacement surgery is an alternative to hip replacement where the surgeon accesses the hip joint from the side or through the buttocks. The anterior procedure uses a very small incision, small as 3-4 inches. It is also known as a muscle-sparing hip replacement because it doesn’t require detaching or cutting muscles or tendons. Consequently, patients usually experience better mobility, fewer activity restrictions, and a shorter recovery time than patients who have had other hip replacement procedures. The location in which the hip joint is accessed is what makes the anterior approach unique; as with other hip replacement, worn hip components are replaced with a titanium socket lined by a plastic or ceramic insert, and a titanium thighbone prosthesis connected to a metal or ceramic ball that rotates within the socket.

What is an anterior hip replacement?
Also known as a mini hip replacement, an anterior hip replacement surgery uses an incision as small as 3 to 4 inches. Because the surgery is approached from the side (anterior) instead of the rear (posterior), it doesn’t require cutting muscles or tendons, which helps reduce your recovery time.

Am I a candidate for an anterior hip replacement?
Your surgeon will discuss with you whether you are a good candidate for an anterior hip replacement. Poor candidates include those with fragile bones, people who are very muscular or obese, and those with hardware from previous hip surgeries.

What happens during an anterior hip replacement surgery?
An anterior hip replacement surgery is performed under general or regional anesthesia. Imaging devices are used to project images on a screen, giving your surgeon an accurate view of your hip joint.

A single incision is made at the front of your hip. The tissues covering your hip joint are moved aside. In some surgeries, a portion of the labrum—rubbery tissue that surrounds the hip socket—is removed, as are any bone spurs that have accumulated in the area.

The femoral head—the “ball” of the “ball-and-socket” joint—is removed, along with some of the femoral neck that supports it. The soft tissues within the socket are removed to prepare for the insertion of the new socket cup. Screws may be used to hold the new cup in place, and a liner is inserted into the cup.

A space is created within your femur, or thigh bone, to hold your new prosthesis. The femoral prosthesis is made up of a stem, which sits inside your femur, and a head, which replaces the ball of your joint.

The materials used in hip replacements vary by patient, surgeon, and facility. Your surgeon will discuss the best options for you.

Hip Resurfacing

The hip joint provides the ability to move your leg through a wide range of motions. The joint is made up of a cup-shaped socket that is part of the pelvis and a ball (femoral head) at the top of your thighbone (femur). The socket, called the acetabulum, is lined with cartilage that cushions the bones and allows smooth leg rotation. If the cartilage starts to wear or degenerate, the hip loses its flexibility and the bones may begin to scrape against each other, causing restricted motion and significant pain. Hip resurfacing is a procedure that replaces worn cartilage and damaged bone by capping the femur with a metal covering and placing a metal cup-shaped liner in the acetabulum. The best candidates for hip resurfacing are physically active and typically younger than 60 years of age. Solid bone tissue in the femur is a requirement for hip resurfacing.

What is hip resurfacing?
Hip resurfacing is a surgical procedure that replaces worn cartilage and bone in the hip joint with metal.

Am I a candidate for hip resurfacing?
This procedure is recommended for patients under 60 who are physically active. Good candidates for hip resurfacing also have solid bone tissue in the femur (thigh bone).

What happens during a hip resurfacing procedure?
Hip resurfacing may be performed under general or regional anesthesia. An incision is typically made along the back of the hip, though other incision locations are not uncommon. The tissues covering your hip joint are moved aside, and tendons in the back of the hip joint are cut to provide your surgeon access to the joint itself.

Your leg is then rotated to separate the femoral head from your pelvis. The soft tissues within the socket are removed to prepare for the insertion of the new socket cup. A rod is drilled into the femoral head and it is reshaped. Then, the new cap is cemented onto your femoral head. Finally, the tendons and muscles affected by the surgery are sutured back into place and the incision is closed.

Revision Hip Replacement

Over time the original components of a total hip replacement can break down and loosen from the bone surface they were once firmly attached to. Revision hip replacement involves the exchange of some or all worn components with new ones. The degree of complexity for this procedure is dependent on the amount of loosening and associated damage to the underlying bone surfaces that may have occurred over time. Specialized components, bone graft, and cement may be used to rebuild the hip joint.

What is a revision hip replacement surgery?
Just like a natural joint, the components of hip replacements can wear down over time. When the components of a previous hip replacement become loose, a revision hip replacement surgery may be performed to preserve the integrity of the joint.

What happens during a revision hip replacement surgery?
A revision hip replacement surgery may be performed under general or regional anesthesia. The old components are replaced with new ones, including a metal cup in your hip socket, a liner inside the cup, and a stem implanted into your femur (thigh bone) with a ceramic ball.

Total Hip Replacement

Total hip replacement is a surgical operation involving the replacement of the cup-shaped hip socket and the ball of the thighbone that have worn from arthritis, or from other conditions which deteriorate the cartilage and bone of the joint. In cases requiring total hip replacement, the cartilage becomes worn and the underlying bone develops spurs and various irregularities that produce pain and loss of motion.

What is a total hip replacement surgery?
The goal of a total hip replacement surgery is to relieve pain from grinding, deteriorated cartilage, bone spurs, and other damage that may have been caused by arthritis, fracture, or the wearing of time.

What happens during total hip replacement surgery?
In a total hip replacement, the head and neck of the femur (thigh bone) and the socket of the hip joint are replaced with prosthetics. This procedure may be performed under general or regional anesthesia. Your surgeon will discuss the best option for you.

The head (or “ball”) and neck of the femur are removed. The damaged cartilage, as well as any bone spurs that may have appeared, is cleared away from the socket of the hip joint. A metal cup is screwed or cemented into the socket, and a spacer—typically made of metal, plastic, or ceramic— is inserted to serve as a lining for the new socket cup.

A metal stem is inserted into the femur, and a ball made of metal or ceramic replaces the femoral head. The materials used in your surgery may vary, but they are all selected to provide smooth, gliding movement of the hip joint.

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ORTHOPEDIC SURGEONS

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Paul K. Edwards M.D.

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William Hefley Jr., M.D.

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Jerry Lorio M.D.

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Kenneth Martin M.D.

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Samuel A. Moore D.O.

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Clay Riley M.D.

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Jason Stewart M.D.

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Nicholas B. Wilson M.D.

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