Hip Care

• For an appointment with a DMC orthopedic specialist, call with (313) 578-6735

The hip joint is a weight-bearing joint that undergoes a lot of stress during daily activities. If you experience hip pain, it can affect your ability to walk, bend, stoop and kneel. If left untreated, chronic hip pain can lead to avoidance of normal daily activities and even disability.

Common causes of hip pain

Normal wear and tear or injury to the hip joint can lead to osteoarthritis, the most common cause of hip pain. Osteoarthritis most often affects people over the age of 40 and is also known as degenerative joint disease. With osteoarthritis, the cartilage between your hip bones wears away, causing the bones to rub against each other. Another common cause of hip pain is bursitis, what happens when a bursa becomes inflamed. A bursa is a small, fluid-filled sac that acts as a cushion between a bone and other moving parts: muscles, tendons, or skin.

A much less common cause of hip pain is inflammatory arthritis, known as rheumatoid arthritis (RA). RA can affect multiple joints in your body, as well as other organs. RA is an inflammatory disease that causes pain, swelling, stiffness, and loss of function in the joints. It occurs when the immune system, which normally defends the body from invading organisms, attacks the membrane lining the joints.

Is Osteoarthritis causing your hip pain?

Below are factors that can contribute to osteoarthritis, which affects an estimated 14% of adults age 25 and older and more than a third of people over age 65.

  • overweight
  • joint injury caused by sports, work or trauma
  • stress on the joint caused by work, such as heavy lifting, knee bending and repetitive motion
  • bone misalignment and muscle weakness

The warning signs of osteoarthritis:

  • stiffness in a joint after getting out of bed or sitting for a long time
  • swelling in one or more joints
  • crunching feeling or the sound of bone rubbing on bone

Treatment approaches to hip pain

  • exercise
  • weight control
  • rest and relief from stress on joints
  • nondrug pain relief techniques and alternative therapies
  • medications to control pain
  • surgery
  • arthroscopy for the removal of loose pieces of bone and cartilage from the joint
  • osteotomy or repositioning of bones
  • joint resurfacing (smoothing out) bones or joint replacement Joint replacement advances in recent years have included the ability, in some cases, to replace only the damaged part of the joint, leaving undamaged parts of the joint intact, and the ability to perform hip replacement through much smaller incisions than previously possible.

Is surgery right for my hip pain?

For many people, surgery helps relieve hip pain. The decision to use surgery depends on several factors. You and your doctor will discuss your age, level of disability, pain intensity and the degree to which arthritis interferes with your lifestyle. DMC orthopedic surgeons and nurses understand that you have a variety of goals for your surgery, including reducing pain, regaining mobility, improving quality of life and regaining the ability to participate in work and recreational activities.

DMC Orthopaedic Specialists offer state-of-the-art treatment for hip pain, including:

For an appointment with a DMC orthopedic specialist, call (313) 578-6735

Birmingham Hip Resurfacing - Great Option for Younger Patients

The Birmingham Hip Resurfacing™ procedure is an alternative to traditional hip replacement. While a total hip replacement requires the removal of the top of the femur, in hip resurfacing only a few centimeters of bone around the femoral head is removed. The hip resurfacing implant used is different than the traditional replacement, and is designed to reduce the rate of post-surgery dislocation. DMC was the first to offer Birmingham Hip Resurfacing, and continues to lead the region in this revolutionary new procedure, recommended for patients with hip arthritis who are less than 60 years old.

Advantages of Hip Resurfacing

Hip resurfacing offers many benefits compared to total hip replacement. It features a technologically advanced design, dramatically reduces joint wear when compared to traditional hip replacement materials. It’s ideal for younger, active people who may outlive a traditional total hip replacement. Other advantages of hip resurfacing include:

  • preservation of healthy bone
  • a reduction in the risk of inaccurate leg length (one leg being longer than the other)
  • reduced recovery time
  • ability to resume a very active lifestyle
  • reduced need for a second surgery

Am I a candidate for hip resurfacing?

This is an alternative to traditional hip replacement for patients ages 40-60 with active lifestyles. Hip resurfacing is a useful therapy for both men and women. The typical patient will be physically active, under 60 years of age, and suffering from hip arthritis, hip dysplasia or avascular necrosis of the hip. If you are older than 60, you may still be a candidate if your bone density is strong enough to support the implant.

For more information about hip resurfacing and DMC’s orthopedic specialists, call (313) 578-6735

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Femur Fracture

A hip fracture is a break in the femur (thigh bone) of the hip joint. The hip joint is a "ball and socket" joint where the femur meets the pelvic bone. The ball part of the hip joint is the head of the femur, and the socket is a cup-like structure in the pelvic bone. Hip fracture is a serious injury and requires immediate medical attention.

About 90 percent of hip fractures happen to people over age 60. The incidence of hip fractures increases with age, doubling for each decade after age 50. Osteoporosis (loss of bone tissue) is a disease that weakens bones.

Women are more prone to osteoporosis than men; therefore, hip fracture is more common among women. They experience about 80 percent of all hip fractures. More than 1.5 million Americans have fractures annually because of osteoporosis.

Symptoms

  • hip pain and/or pain that can be felt in the knee
  • low back pain
  • inability to stand or walk
  • bruising or swelling
  • foot turned out at an odd angle, making the leg look shorter

Treatment

A fracture of the hip is generally treated with surgery. Your physician may use metal devices to strengthen and stabilize the joint. In some situations, a total hip replacement may be performed. The type of surgical repair will depend upon the type of hip fracture. Your physician will determine the best procedure for you, based on your individual situation.

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Hip Dislocation Repair

A dislocated hip is an emergency that requires immediate treatment. It occurs when a great amount of force pushes the head of the thighbone (femur) out of its socket into the hip bone (pelvis). In approximately 90% of cases, the thighbone is pushed out of its socket in a backwards direction (posterior dislocation). The hip then becomes bent and twisted toward the middle of the body. Hip dislocations most commonly occur from motor vehicle accidents and falls, but can also be a complication of hip replacement surgery.

Symptoms

  • severe pain
  • inability to move one leg
  • no feeling in the foot or ankle (a result of nerve damage)

Treatment

The first step is usually to try and reposition the hip joint by applying force to the leg without surgery. Called a closed reduction of the hip replacement, it is performed under anesthesia.

If the dislocation occurs with additional damage such as a fracture, or involves a hip implant, an open reduction surgery may be needed. In this procedure surgeons must go in and manipulate the femur and hip and/or reposition the implants.

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Total Hip Replacement

Joint replacement, also called arthroplasty, is a surgical procedure to replace a damaged joint with a prosthesis, or artificial joint. This surgery may be considered following a hip fracture (breaking of the bone) or for someone who has severe arthritis, though the most common condition needing a hip replacement to relieve symptoms is arthritis.

The following are the various forms of arthritis that can occur:

  • osteoarthritis, a degenerative, joint disease that affects mostly middle-aged and older adults, causes the breakdown of joint cartilage and adjacent bone in the hips
  • rheumatoid arthritis, which causes inflammation of the synovial membrane and results in excessive synovial fluid, can lead to pain and stiffness
  • traumatic arthritis, arthritis due to injury, can cause damage to the articular cartilage of the hip

Symptoms

  • bone fracture from a fall or injury
  • joint soreness after inactivity or periods of overuse of a joint
  • joint pain which increases with activity throughout the day
  • muscle atrophy around joints caused by inactivity can increase pain
  • pain and stiffness affecting posture, coordination and ability to walk
  • pain in the groin, inner thigh, or buttocks and a pronounced limp

Treatment

  • anti-inflammatory medications
  • pain medications
  • limiting painful activities
  • assistive devices for walking (such as a cane)
  • physical therapy
  • hip replacement surgery
  • Surgery and Prostheses

Traditional Hip Replacement

A traditional hip replacement involves an incision (cut) about 10 to 12 inches long over the hip joint. Newer approaches are being developed that use one or two smaller incisions to perform the procedure, called minimal incision hip replacement or minimally invasive hip replacement.

Anterior Hip Replacement

DMC Orthopaedic surgeons were some of the first in Michigan to be trained in this minimally invasive hip replacement and resurfacing procedure. The different angle at which your surgeon performs the surgery means that no muscles need to be cut, meaning your recovery time is shorter and less painful.

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MAKOplasty® Total Hip Replacement

The use of this highly advanced robotic arm technology can:

  • Enable surgeons to accurately replace the joint by practicing on a model of the patient’s hip
  • Facilitate optimal implant positioning to result in a more natural feeling following surgery
  • Result in a more rapid recovery and shorter hospital stay when compared to traditional total joint replacement surgery
  • Promote a rapid relief from pain and return to daily activities

The RIO robotic arm system assists the orthopedic surgeon in several ways. First, it provides patient-specific three dimensional modeling for pre-surgical planning. Then, during the procedure, the combination of the robotic arm and stereo tracking technology provides the surgeon with real-time visual, tactile and auditory feedback, enabling reproducible precision and optimal positioning of the implant(s). It is this level of accuracy that facilitates optimal implant positioning and alignment, resulting in a more natural motion following surgery.

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