The doctors at Newton Wellesley Orthopedic Associates in Newton and Wellesley, MA, diagnose and treat hip conditions such as hip arthritis and perform hip surgery when needed.
Conditions Affecting the Hip
Arthritis of the hip joints can cause pain, stiffness, loss of movement and even bone spurs. Treatments include medication, exercise and surgery.
Labral tears of the hip are becoming an increasingly recognized cause of hip pain in the athlete. The labrum is a ring of cartilage encircling the hip socket (the acetabulum) which normally provides a watertight seal of the hip joint. In some patients, there may be a bony protrusion on the femoral neck (on the “ball” side of the joint) called a cam lesion, which can impinge on the labrum in certain extreme positions of hip motion, making the patient more susceptible to a labral tear. Similarly, other patients may have a “pincer” lesion in which the anterior, or front facing portion of the acetabulum is overly prominent, causing impingement on the labrum in extremes of hip position and resulting in labral tears.
Patients with a labral tear may experience deep dull pain in the groin, which is aggravated by high hip flexion or internal rotation. This type of pain may be brought on with certain physical exam maneuvers. Often a history and physical exam are enough to make the diagnosis of labral tear. X-rays may demonstrate the “cam” or “pincer” lesions and MRI may show the actual cartilage tear itself.
Treatment usually consists of a period of rest, modification of activity, anti-inflammatory medication and physical therapy. If pain with activity persists, a cortisone injection in the hip joint usually relieves the pain. In patients who do not experience longstanding pain relief with a cortisone injection, hip arthroscopy is the current gold standard of surgical treatment. Open hip dislocation may need to be performed in patients with highly abnormal bone structure around the hip.
See the video below to learn how a labral tear of the hip is repaired with arthroscopy.
Following hip arthroscopy, physical therapy is usually required. See Dr. Hanmer’s hip arthroscopy postoperative protocol.
Inflammation of the fluid-filled sacs in the hip called bursa is a painful condition called trochanteric bursitis. Causes include injury, overuse of the hip joint, poor posture and hip bone spurs. Medication, physical therapy and surgery are some of the treatment options.