Hip
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Hip
Anterior Hip Replacement
Anterior Hip Replacement is a minimally invasive, muscle-sparing surgery that uses a different approach compared to traditional hip replacement surgery. Traditionally, surgeons make the incision on the side (laterally) or at the back (posteriorly) of the hip, which involves cutting major muscles to reach the hip joint.
Hip Trauma Reconstruction
Hip trauma is an injury in the hip due to the impact caused by incidents such as a car accident or a hard fall. The injury can be a bone break or dislocation or both.
Revision Hip Surgery
Revision hip surgery is a repeat hip surgery performed in certain patients to correct the problems or complications of previous hip surgery and overcome its limitations. The hip joint is one of the body's largest weight-bearing joints and is the point where the thighbone (femur) and pelvis (acetabulum) join.
Bilateral Total Hip Replacement
Bilateral Total Hip Replacement, also known as a double hip replacement, is a surgical procedure where both hip joints are replaced with artificial components during a single surgery. This procedure is typically considered for individuals who have significant pain or loss of function in both hips due to conditions such as arthritis, osteonecrosis, bone fractures, or other bone disease.
Direct Anterior Hip Replacement
Direct anterior hip replacement is a minimally invasive hip surgery to replace the hip joint without cutting through any muscles or tendons as against traditional hip replacement that involves cutting major muscles to access the hip joint.
Periprosthetic Hip Fracture Management
Total hip replacement or hip arthroplasty is a surgical procedure in which the worn out or damaged parts of the hip joint are removed and replaced with artificial components called prostheses or implants.
Robotic Assisted Hip Replacement
Robotic-assisted hip replacement is a minimally invasive surgical procedure that involves the use of a specialized robotic system to remove the damaged parts of a hip joint and replace them with an artificial prosthesis or implant.
Outpatient Anterior Approach Hip Replacement
With improved technology and advances in anesthesia and pain control, hip replacement surgery has evolved and is now being offered in an outpatient setting. Outpatient anterior approach hip replacement refers to surgery accessed from in front of the hip in an outpatient setting. It is a minimally invasive procedure that has been developed to cause less muscle damage, faster recovery, and less disruption in a patient’s life.
Computer-Navigated Total Hip Replacement
For a successful total hip replacement, accurate positioning of the implants is crucial to accomplish a good clinical outcome. Computer-navigated total hip replacement is an advanced technology developed to provide more accurate positioning of an implant. Hip replacement through computer navigation provides information and guidance to the surgeon for precise positioning of implants.
Complex Primary Hip Replacement
Primary hip replacement or hip arthroplasty is a surgical procedure in which the worn out or damaged parts of the hip joint are removed and replaced with artificial components called prostheses or implants that are made of metal, plastic, or ceramic.
Periprosthetic Hip Fractures
Hip replacement is a surgical procedure in which the damaged cartilage and bone are removed from the hip joint and replaced with artificial components. Any resulting fractures or breaks in the bone around the implant are called periprosthetic hip fractures.
Acetabular Fracture
An acetabular fracture is a break in the acetabulum (ball-and-socket portion) of the hip joint. It usually occurs during high-energy injuries.
Femoral Neck Fracture
The hip is a ball-and-socket joint made up of the head of the thigh bone or femur that acts as the ball and fits into the rounded socket of the hip bone or acetabulum. The neck of the femur is the region just below the ball of the hip joint.
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. Hip joint is most commonly affected; however, the knee and shoulder may also be involved.
Femoral Shaft Fracture
A femoral shaft fracture is a crack or break anywhere along the long and straight section of the femur (thighbone) due to high-energy trauma or low-energy trauma in osteoporotic patients. The femur is the strongest and longest bone in the body.
Hip Dislocation
The hip joint is a “ball and socket” joint. The “ball” is the head of the femur or thighbone, 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).
Hip Instability
Injury or damage to these structures can lead to a condition called hip instability when the joint becomes unstable.
Developmental Dysplasia
Developmental dysplasia of the hip (DDH) or hip dysplasia is a condition that is seen in infants and young children because of developmental problems in the hip joint. The femur (thighbone) partially or completely slips out of the hip socket leading to dislocation at the hip joint. It is most common in the first-born baby with a family history of the disorder.
Osteoarthritis of the Hip
Osteoarthritis, also called degenerative joint disease, is the most common form of arthritis. It occurs most often in the elderly. This disease affects the tissue covering the ends of bones in a joint called cartilage. In osteoarthritis, the cartilage becomes damaged and worn out, causing pain, swelling, stiffness and restricted movement in the affected joint.
Femur Fracture
The femur or thigh bone is the longest and strongest bone in the body, connecting the hip to the knee. A femur fracture is a break in the femur. The distal femur is the lower part of the thigh bone which flares out like an upside-down funnel and its lower end is covered by a smooth, slippery articular cartilage that protects and cushions the bone during movement. Fracture of the distal femur may involve the cartilaginous surface of the knee as well and result in arthritis.
Periprosthetic Hip Infection
A very small percentage of patients (less than 1%) who undergo hip replacement may develop an infection around the hip joint following surgery. This infection is called a periprosthetic hip infection.
Hip Joint
The hip joint is the largest weight-bearing joint in the human body. It is also referred to as a ball and socket joint and is surrounded by muscles, ligaments, and tendons. The thigh bone or femur and the pelvis join to form the hip joint.
Any injury or disease of the hip will adversely affect the joint's range of motion and ability to bear weight.
The hip joint is made up of the following:
- Bones and joints
- Ligaments of the joint capsule
- Muscles and tendons
- Nerves and blood vessels that supply the bones and muscles of the hip
Bones and Joints
The hip joint is the junction where the hip joins the leg to the trunk of the body. It is comprised of two bones: the thigh bone or femur and the pelvis which is made up of three bones called ilium, ischium, and pubis. The ball of the hip joint is made by the femoral head while the socket is formed by the acetabulum. The Acetabulum is a deep, circular socket formed on the outer edge of the pelvis by the union of three bones: ilium, ischium, and pubis. The lower part of the ilium is attached by the pubis while the ischium is considerably behind the pubis. The stability of the hip is provided by the joint capsule or acetabulum and the muscles and ligaments which surround and support the hip joint.
The head of the femur rotates and glides within the acetabulum. A fibrocartilagenous lining called the labrum is attached to the acetabulum and further increases the depth of the socket.
The femur or thigh bone is one of the longest bones in the human body. The upper part of the thigh bone consists of the femoral head, femoral neck, and greater and lesser trochanters. The head of the femur joins the pelvis (acetabulum) to form the hip joint. Next, to the femoral neck, there are two protrusions known as greater and lesser trochanters which serve as sites of muscle attachment.
Articular cartilage is the thin, tough, flexible, and slippery surface lubricated by synovial fluid that covers the weight-bearing bones of the body. It enables smooth movements of the bones and reduces friction.
Ligaments
Ligaments are fibrous structures that connect bones to other bones. The hip joint is encircled with ligaments to provide stability to the hip by forming a dense and fibrous structure around the joint capsule. The ligaments adjoining the hip joint include:
Iliofemoral ligament: This is a Y-shaped ligament that connects the pelvis to the femoral head at the front of the joint. It helps in limiting the over-extension of the hip.
Pubofemoral ligament: This is a triangular shaped ligament that extends between the upper portion of the pubis and the iliofemoral ligament. It attaches the pubis to the femoral head.
Ischiofemoral ligament: This is a group of strong fibers that arise from the ischium behind the acetabulum and merge with the fibers of the joint capsule.
Ligamentum teres: This is a small ligament that extends from the tip of the femoral head to the acetabulum. Although it has no role in hipmovement, it does have a small artery within that supplies blood to a part of the femoral head.
Acetabular labrum: The labrum is a fibrous cartilage ring which lines the acetabular socket. It deepens the cavity, increasing the stability and strength of the hip joint.
Muscles and Tendons
A long tendon called the iliotibial band runs along the femur from the hip to the knee and serves as an attachment site for several hip muscles including the following:
Gluteals: These are the muscles that form the buttocks. There are three muscles (gluteus minimus, gluteus maximus, and gluteus medius) thatattach to the back of the pelvis and insert into the greater trochanter of the femur.
Adductors: These muscles are located in the thigh which helps in adduction, the action of pulling the leg back towards the midline.
Iliopsoas: This muscle is located in front of the hip joint and provides flexion. It is a deep muscle that originates from the lower back and pelvis and extends up to the inside surface of the upper part of the femur.
Rectus femoris: This is the largest band of muscles located in front of the thigh. They also are hip flexors.
Hamstring muscles: These begin at the bottom of the pelvis and run down the back of the thigh. Because they cross the back of the hip joint, they help in extension of the hip by pulling it backward.
Nerves and Arteries
Nerves of the hip transfer signals from the brain to the muscles to aid in hip movement. They also carry the sensory signals such as touch, pain, and temperature back to the brain.
The main nerves in the hip region include the femoral nerve in the front of the femur and the sciatic nerve at the back. The hip is also supplied by a smaller nerve known as the obturator nerve.
In addition to these nerves, there are blood vessels that supply blood to the lower limbs. The femoral artery, one of the largest arteries in the body, arises deep in the pelvis and can be felt in front of the upper thigh.
Hip Movements
All of the anatomical parts of the hip work together to enable various hip movements. Hip movements include flexion, extension, abduction, adduction, circumduction, and hip rotation.
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