Hip – structure, functions, operation. Hip diseases and their treatment

Proven content

The hip is one of the most stable joints in our body. Unfortunately, because of the weight on him, the likelihood of later arthritis problems due to the extra pressure is increasing. Pain in the hip can be caused by trauma to the muscles, tendons, or small fluid-filled bags (synovial bursae) that cushion and moisturize the joints.

Hip – structure

The hips are the area on both sides of the pelvis. The pelvic bone consists of 3 parts:

1. Ilium (Latin os ilium) – wide, flared part of the pelvis;
2. The ischial bone (Latin os ischii) – one of the bones that helps shape the hip;
3. Pubic bone (Latin os pubis) – lower, back part of the pelvis.

The hip joint is a complex ball joint that supports the weight of the body and controls the movement of the upper leg. It consists of two main parts: the spherical head at the top of the femur, which fits into the rounded acetabulum. Tissue strands, called ligaments, hold the joint together and provide stability.

The structure of the hip joint allows a wide range of motion needed for daily activities such as walking, squatting and climbing stairs.

Hip – functions and operation

A healthy hip joint consists of the femur, femoral head, acetabulum, tendons, ligaments, and cartilage.

Ligaments work like elastic bands – they keep bones in place while the muscles around the joint lengthen and shorten, causing it to move. The spherical-pitting surfaces (femoral head and acetabulum) are covered with articular cartilage, which absorbs the bones and allows them to slide easily over each other.

The hip joint is surrounded by a bag, and the space inside the joint (joint cavity) contains synovial fluid. This fluid, which supplies nutrients to the joint and cartilage, is produced by the synovium that lines the joint cavity. In a healthy hip, this membrane produces a small amount of fluid that lubricates and almost completely eliminates friction in the hip joint.

Ideally, all these parts of the hip work harmoniously, allowing the joint to move easily and painlessly, thus preventing hip problems. Hip strengthening exercises can help keep your hips strong and healthy.

The hip and the role of blood vessels

Bones are living tissue and, like any living tissue, they rely on blood vessels to supply blood to keep them alive. In the hip joint, the blood supply goes to the head of the femur (the head of the femur) through the femoral neck, the thinner bone area that connects the ball of the femur to its shaft.

The lack of a normal blood supply can reduce the supply of oxygen and nutrients to the femoral head, causing the bone to die. This impairment of the blood supply to the bone is called osteonecrosis of the hip, also known as sterile osteonecrosis, and can lead to bone deterioration and joint deformities that often require hip replacement.

See also: The functions of the circulatory system

Hip – hip movement

The hip joint is one of the most active joints in the human body and is designed for many different types of movement. It has three main axes that allow movement in all three degrees of freedom. All axes pass through the center of rotation of the hip joint.

1. Abduction – sideways movement of the leg from the midline of the body;
2. Adduction – internal leg movement towards the midline of the body;
3. Flexion – bending forward or lifting the leg towards the body;
4. Extend – Extend your legs backwards away from your body.

Any deviation from the correct alignment of the acetabular joint can lead to:

1. Improper positioning in the leg causing overload and increased wear of cartilage, and thus osteoarthritis;
2. Leg length discrepancies;
3. Retraction of the femoral head;
4. Limited range of motion.

One of the main goals of total hip replacement surgery is to restore the joints to their natural position.

Hip – hip problems

Worldwide, the number of people suffering from arthritis is approximately 355 million, including over 151 million with osteoarthritis. In the United States alone, about 10 million people have reported a diagnosis of osteoarthritis of the hip. Although osteoarthritis can develop without any apparent risk factors, it often occurs in patients with a family history of the disease and in the elderly, obese, or after an injury that puts strain on the hip joint.

Aseptic osteonecrosis, also known as aseptic necrosis, is a painful condition that often leads to debilitating osteoarthritis. While it can affect any bone, sterile osteonecrosis most commonly occurs in the hip joints. In the United States, more than 20 people are admitted to hospitals each year to treat osteonecrosis.

Hip dysplasia is usually hereditary and can affect a patient’s hip. It is often found in the left hip and is more common in women, children and those born in the gluteal position (babies come out with the buttocks or feet forward, as opposed to when the baby is facing forward). Dysplasia occurs in about 1 in 1000 births.

Despite these numbers, great options are available to treat conditions or injuries that affect the hip joint. Many patients found that hip replacement surgery was a viable solution to eliminate pain and return to an active lifestyle. Worldwide, nearly 2,9 million joint replacement procedures are performed annually, including over 1,4 million hip replacement procedures.

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Hip – the most common hip diseases

Walking, running, sitting, and even driving are activities that engage the hip – one of the most busy joints in the human body. When our hip joint is healthy, we usually don’t realize how important it is, but as soon as pain or stiffness in the hip joint begins to affect the joint, its role in most of our daily tasks suddenly comes to the fore.

Osteoarthritis of the hip joints (osteoarthritis)

One of the most common conditions of the hip joint is osteoarthritis, in which joint cartilage is damaged by wear or trauma, causing severe pain and limiting mobility.

In a healthy hip joint, the surfaces of the femoral head and the acetabulum are smooth and covered with a layer of articular cartilage. In an arthritic hip joint, the smooth surface of cartilage in both parts of the joint is gradually worn down as a result of age, weight, disease, or injury.

Osteoarthritis develops when damage occurs to the surface of the cartilage as a result of excessive stress. The protective layer becomes rough and the surfaces of the hip joint can no longer glide smoothly; the arthritic joint begins to wear down, causing the bone surfaces to rub directly against each other. Damaged cartilage loses its elasticity, and a painful impact is transferred directly to the bone below.

Risk factors that may contribute to the occurrence of this condition are:

1. Advanced age;
2. Overweight or obesity;
3. Hip instability (dysplasia);
4. Hip cartilage stress related to exercise or sports;
5. Previous hip injury.

Hip dysplasia

Hip dysplasia is the medical term for instability or looseness in the hip joint. There are typically two abnormal hip anatomy changes leading to a dysplastic hip joint.

1. Deformed shallow hip socket that is unable to hold the femoral head deeply and securely in place.
2. The rounding at the upper end of the femur (femoral head) is deformed and not seated properly in the hip socket.

These mismatched bones are finally starting to wear down. As a result of this wear and tear, the joint is constantly trying to repair itself by producing new cartilage, and therefore the joint may degrade due to abnormal abrasion or may not be able to support a person’s weight and become mechanically unstable, causing hip pain. Hip ligaments can also become loose or stretch. When the femoral head has completely come out of its socket, it is said to be a dislocation.

This altered hip anatomy can also cause:

1. asymmetry in the position of the legs;
2. reduced range of motion on the affected side;
3. early osteoarthritis.

Patients can vary in severity of dysplasia, from a completely dislocated hip to a hip that is only slightly off-line and may not develop symptoms until later in life.

Aseptic bone necrosis

Aseptic osteonecrosis, also known as aseptic necrosis, is a condition that results from the temporary or permanent loss of blood supply to the affected bones. In the hip joint without adequate blood flow, the bone tissue dies and is no longer able to maintain or repair itself, causing the femoral head to collapse and flatten. As a result, the head of the femur no longer fits perfectly within the hip socket, often leading to debilitating osteoarthritis.

Aseptic osteonecrosis can be caused by several factors, including mechanical disturbance, alcoholism, excessive steroid use, trauma, thrombosis, or hypertension. In some cases, aseptic osteonecrosis is idiopathic, which means that a clear cause of the condition cannot be established.

It is estimated that over 20 people worldwide are hospitalized each year for the treatment of hip bone necrosis. In many cases, both hips are affected. When sterile bone necrosis is in an advanced stage, the condition usually manifests as osteoarthritis of the hip. In this case, your surgeon will likely recommend that you replace the hip joint with an artificial hip joint.

In all of these conditions, the hip joint is damaged or dysfunctional in some way, resulting in increased hip pain and decreased mobility. Fortunately, treatment options are available to help relieve symptoms of hip pain, reduce stiffness, and restore normal hip function.

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Diagnosis of hip problems

Diagnosis of hip disorders usually begins with a complete history and physical examination by a physician to understand your overall health, the severity of hip pain, and how it affects your daily activities. Physical checkups typically include standing, sitting, and lying posture testing, and gait analysis (assessing how a person walks) – helping to confirm or rule out potential diagnoses. This first physical examination also allows the clinician to evaluate the mobility, strength, alignment, and range of motion of the hip.

Typically, diagnosis of hip disease or trauma is based on an X-ray to determine the location and extent of bone and cartilage damage. Your doctor may also order one or more specialized tests, depending on the known or suspected causes of your pain. Laboratory results, ultrasound, and even computed tomography (CT) or magnetic resonance imaging (MR) can also contribute to the diagnosis and the resulting personalized treatment plan.

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Hip diseases – treatment

Fortunately, there are many options for treating hip conditions and injuries, including hip surgery, hip replacement, and hip exercises. Depending on the severity of your condition and pain, your doctor may suggest you undergo nonsurgical or surgical treatment.

When it comes to nonsurgical treatment, your doctor may recommend rest, gentle and regular hip exercises, anti-inflammatory medications, adequate sleep, weight loss, or perhaps an assistive device such as a walking stick. However, if these treatments do not improve symptoms or the damage is more advanced, your doctor may advise that a total hip replacement is probably the best option for reducing pain and restoring your previous level of activity and quality of life. While this can result in post-operative hip pain, the long-term benefits usually outweigh the temporary discomfort.

Every year, nearly 1,4 million hip replacement procedures are performed worldwide. To support surgeons during these procedures, advanced orthopedic technologies, such as software-driven tools, are constantly developed and improved.

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How to take care of your hips?

Keeping your hips strong and healthy is important to being able to sit, stand, walk, and make many other movements. Hip pain can interfere with our daily activities. Hip pain can come from many sources, including arthritis, overstrain, injury or simply wear and tear. It’s worth following these tips to keep our hips strong and pain-free.

Lose unnecessary kilograms

Extra pounds put more pressure on your hips. For every ten kilograms of extra weight that we “carry”, it can put fifteen kilograms of pressure on the hips and knees. Losing even a small amount of weight can have a big impact on your joints.

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Exercise regularly

Exercise is a great way to keep your muscles strong and your joints flexible. The stronger our muscles are, the more support they provide to our joints. Moreover, it will help us lose weight or maintain a healthy weight. While exercise is important, we must still listen to our body. If you experience any sharp or shooting pain, stop exercising immediately.

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Choose lighter physical activities

Let’s choose lighter activities like walking, cycling, yoga, and strength training. Swimming and aqua aerobics are also good options as they allow you to strengthen your muscles without putting strain on your joints. Stretching is also helpful in keeping your hips flexible and increasing your range of motion. Avoid sports such as running, football and intense aerobics that strain our joints.

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Pay attention to your diet

According to the Arthritis Foundation, certain diets can relieve symptoms caused by osteoarthritis. If your hip pain is the result of arthritis, it is recommended that you eat foods that reduce inflammation such as olive oil, dark green leafy vegetables, nuts, fatty fish, and high-fiber foods.

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Practice good posture

When we stand, walk, and even sit in the wrong posture, this puts unnecessary stress on the muscles that support the hips. Abnormal postures, such as walking with feet upside down, excessively sitting, or standing with bent hips, can prevent the hip joint from working properly.

See also: Disorders of posture, gait and muscle tension; involuntary movements and tremors

Reduce the risk of falls

One of the most serious fall injuries is a hip fracture. There are many times when hip fractures occur in the home, but there are steps you can take to stay safe. To avoid falls, take home precautions such as remove trip hazards, improve lighting, add handrails in the shower, and place handrails on the stairs.