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Hip Pain Tips

Causes and Symptoms of Avascular Necrosis of the Hip

Dr. P. Sharat Kumar 90% (103 ratings)
FFSEM, MFSEM, DIP - SEM GB & I, MCh - Orthopaedics, MS - Orthopaedics, MBBS
Orthopedist, Hyderabad
Causes and Symptoms of Avascular Necrosis of the Hip

Avascular Necrosis, also termed as Ischemic Bone Necrosis or Osteonecrosis is a medical condition characterized by the bone death on being deprived of blood. The condition is known to occur in the shoulder, ankles, and knees. However, the part of the body most affected by Avascular Necrosis is the hip. In this article, we will describe the conditions that contribute towards Avascular Necrosis of the hip along with the associated symptoms.

Factors that lead to Avascular Necrosis of the hip
The supply of blood to the bones may be interrupted by a myriad of factors some of which include

1. Certain medical conditions and health disorders such as

  • Gaucher's disease: A genetic disorder resulting from glucocerebrosidase enzyme deficiency. As a result, glucocerebroside gets deposited in the cells of the macrophage-monocyte system.
  • Sickle cell anemia: A genetic disorder which results in the RBC's appearing like a sickle cell instead of being round shaped.

Both of these conditions bring about a significant reduction in the supply of blood to the bones resulting in Avascular Necrosis.

Certain inflammatory conditions that may damage the arteries and trigger Avascular Necrosis of the hip include autoimmune diseases, pancreatitis or HIV infection.

2. Extensive and prolonged use of corticosteroids: Often used as non-inflammatory drugs, corticosteroids can play a contributing role, resulting in Avascular Necrosis (non-traumatic). The fatty substances are usually broken down by the body. However, the use of corticosteroids may affect this breakdown as a result of which the fatty substances start piling up in the blood vessels, constricting their size. The constricted blood vessels, in turn, reduces the supply of blood to the bones to a great extent.

3. An injury or a fracture affecting the femur: A hip fracture or a dislocation that affects the upper half of the thigh bone or the femur acts as a potential threat, triggering a traumatic Avascular Necrosis (AVN) of the hip.

In some case, radiation therapy or chemotherapy for cancer can go a long way in interfering with the ability of the bone (weakens the bone) to receive blood, causing bone death.

People who are into heavy drinking stand a greater risk of suffering from AVN. An increased consumption of alcohol causing constriction and narrowing of the blood vessels interfering with the flow of blood to the bones.

Symptoms characteristic of AVN of the hip

  1. Unfortunately, the initial stages of AVN are asymptomatic. However, as the condition progresses into later stages, a person may experience pain and discomfort, particularly while exerting pressure on the bone affected by the condition.
  2. As the bone and the adjacent joints deteriorate and collapse further, a person may experience great difficulty in using the joint altogether.
  3. In some cases, the condition may progress and affect both the hips (Avascular Necrosis Bilateral).

In case you have a concern or query you can always consult an expert & get answers to your questions!

4975 people found this helpful

Hip Replacement - Why Get A Radiological Evaluation Done?

Dr. Manjari Gupta 87% (10 ratings)
MBBS Bachelor of Medicine and Bachelor of Surgery, MD - Radiodiagnosis
Radiologist, Ghaziabad
Hip Replacement - Why Get A Radiological Evaluation Done?

Radiology is a special branch of medical science that uses various techniques of imaging for the diagnosis and the treatment of several types of diseases in the body. The different types of imaging techniques used in radiology are X-rays, Computerised Tomographic scan (CT Scan), ultrasound, Magnetic Resonance Imaging (MRI) and nuclear medicine which includes Positron Emission Tomography(PET).

Role played in evaluating hip replacement
Hip replacement surgeries have become extremely common in the recent times, and radiological evaluation remains the mainstay of the overall hip replacement procedure. Thus, the role played by radiology is quite significant in such situations. All the specific anatomical landmarks and the measurements are used to make sure the placement is perfect during the hip replacement surgery. Radiological imaging helps in the assessment of the following conditions that are as discussed below.

The length of leg
The inequality in the length of the two legs is prevalent after a hip replacement surgery which can create a great deal of discomfort and inconvenience to the patients. A greater difference in the length of the two legs increases the chances of dislocation, and this is a situation where radiological evaluation plays a crucial role. With the help of radiological imaging, the length of the legs can be made almost equal.


The horizontal center of rotation
In this case, horizontal center of rotation helps in the assessment of the acetabular component of the prosthesis. This is calculated by the measurement of the distance between the center of the head of the femur and the acetabular teardrop. This distance should be bilaterally equal, and it is just not possible without the help of the imaging techniques of radiology.

Acetabular inclination
The acetabular inclination is the angle formed between the face of the cup and the transverse axis. If the angle is less, then it results in a stable hip, but the abduction is limited. On the other hand, if the angle increases then there are high chances of dislocation of the hip. Thus, with the help of radiological evaluation, proper and effective angular inclination is given which is optimum for the patient.

The stem positioning of the femur
The main aim of the stem positioning of the femur in a hip replacement surgery is placing the stem in a position which is neutral within the shaft. To get a proper idea of the positioning, the imaging techniques are of utmost importance which cannot be achieved perfectly without the imaging.

Thus, the crucial role the different techniques of radiological imaging plays during the overall procedure of a hip replacement surgery can be perceived. With the use of the different imaging techniques, the results obtained are closer to perfection. In case you have a concern or query you can always consult an expert & get answers to your questions!

 

3252 people found this helpful

Causes and Symptoms of Avascular Necrosis of Hip

Dr. P. Sharat Kumar 90% (103 ratings)
FFSEM, MFSEM, DIP - SEM GB & I, MCh - Orthopaedics, MS - Orthopaedics, MBBS
Orthopedist, Hyderabad
Causes and Symptoms of Avascular Necrosis of Hip

Avascular necrosis is localised death of the bone. Necrosis can occur due to traumatic injury, side effects of drugs or disease. The dead areas of the bone do not function normally, they weaken and they can collapse. Avascular necrosis eventually leads to the joints attached to the dead bone deteriorating. Avascular necrosis can occur in the knees, shoulder, waist and ankles, but the hip joint is the most commonly affected.

Causes of Avascular Necrosis

1. Traumatic injury to the affected bone, like fractures and dislocation, is a common cause
2. Use of steroid medication
3. Excessive alcohol consumption and smoking
4. Radiation and chemotherapy treatments can lead to avascular necrosis
5. Patients with underlying diseases such as systemic lupus erythematosus, diabetes mellitus, vasculitis, and inflammatory bowel disease are at risk

6. Patients with blood and bone marrow diseases such as sickle cell disease, leukaemia, Gaucher's disease or thalassemia are also at risk

 

Symptoms of Avascular Necrosis

1. Necrosis can begin with no pain in the abnormal bone
2. But with time and use, the pain develops
3. When the hip is affected, pain in the groin is common, especially when walking
4. The ball of the hip collapses as necrosis progresses which leads to pain whenever the hip is rotated or is to bear weight while walking

In case you have a concern or query you can always consult an expert & get answers to your questions!

5123 people found this helpful

Hip Replacement - What All Should Be Considered?

Dr. Kunal Makhija 85% (10 ratings)
MBBS Bachelor of Medicine and Bachelor of Surgery, MS - Orthopaedics, Fellowship In Joint Replacement, Fellowship In Minimal Invasive Subvastus Knee Replacement
Orthopedist, Navi Mumbai
Hip Replacement - What All Should Be Considered?

Hip replacement is a surgery in which a specialist doctor surgically removes an agonizing hip joint afflicted with arthritis and replaces it with a man-made joint usually produced using metal and plastic elements. It is usually done when all other treatment choices have been tried and have proven unsuccessful in providing satisfactory pain alleviation. The technique is to mitigate the pain in ahip joint, in order to make walking and other physical exercises easier.

The surgical procedure is as follows:

  • Hip replacement surgery can be performed generally or by utilizing what is called a non-obtrusive method. The primary difference between the two methodologies is the number of entry points needed for the surgery.
  • During standard hip replacement surgery, you are given general anesthesia to relax your muscles; this will keep you from feeling any pain during the surgery or being awake during the surgery. A spinal sedative might be given to counteract pain as an add-on option.
  • The specialist will then make a cut at the edge of the hip and move the muscles connected to the highest point of the thighbone to uncover the hip joint.
  • Next, the ball part of the joint is taken out by cutting the thighbone with a saw. At this point a fake joint is attached to the thighbone using a material that allows them to stay intact.
  • The specialist then readies the surface of the hipbone - evacuating any harmed ligament - and joins the substituting attachment to the hipbone.
  • The new ball part of the thighbone is then embedded into the new joint part of the hip. The specialist then reattaches the muscles and shuts the entry point.

There are some things you need to keep in mind and be attentive about, post the surgery. These are as follows:

  1. You will probably remain in the healing facility for four to six days and may need to remain in bed with a pad between your legs to keep the new hip joint set up.
  2. A seepage tube will be set in your bladder to help you urinate without having to walk to the bathroom.
  3. Non-intrusive treatment usually starts the day after surgery and within the days you can go around with a walker or a walking stick.
  4. You will continue with the non-intrusive treatment for quite a long time which could be a number of months post the surgery.
  5. For anywhere in the range of six to twelve months after hip replacement surgery, rotating or putting pressure on the operated leg needs to be limited to a great extent. You need to likewise not cross the operated leg past the midline of the body nor turn it inwards.
  6. You cannot twist the hip past ninety degrees. This includes both twisting forward at the abdomen and crouching.
  7. Your physical advisor will tell you the methods and equipment that will help you comply with the above rules and precautionary measures while performing every day exercises.

In case you have a concern or query you can always consult an expert & get answers to your questions!

4655 people found this helpful

Is Arthritis Causing Your Hip Pain?

Dr. P. Sharat Kumar 90% (103 ratings)
FFSEM, MFSEM, DIP - SEM GB & I, MCh - Orthopaedics, MS - Orthopaedics, MBBS
Orthopedist, Hyderabad
Is Arthritis Causing Your Hip Pain?

If you are experiencing joint stiffness in your hip along with pain and tenderness, you could be suffering from hip arthritis or osteoarthritis. Osteoarthritis accounts for being the most common form of arthritis. It is referred to as degenerative joint disease and old-age arthritis and usually, occurs because of age-related issues. The condition occurs when injury and inflammation of a joint lead to the breakdown of the cartilage tissue, causing pain, swelling, and deformity.

How hip arthritis affects the hip joint?
People who are affected by osteoarthritis of the hip may have difficulty in walking properly. Diagnosis in the early stage is difficult as pain may occur in various locations such as the thigh, groin, knee or buttocks.

The underlying causes
The factors responsible for osteoarthritis include increasing age, joint injury and excess body weight. Some other factors may also be responsible. They are as follows:

  1. When the joints have formed improperly.
  2. In case of inherited defects in the cartilage.
  3. When a person puts excess stress on the hip joint because of being overweight or due to certain activities and motions.

How it can be detected?
The different symptoms of hip arthritis or osteoarthritis are as follows:

  1. Joint stiffness, especially after waking up in the morning.
  2. Joint stiffness after sitting for a long period.
  3. Swelling, pain, and tenderness in the hip joint.
  4. A crunching feeling or sound of bones rubbing against one another.
  5. The inability to move the hip for carrying out daily activities.

Treatment
The aim of osteoarthritis treatment is to improve the patient’s ability to move about so that his regular life is less affected. The function of the hip and pain management are other targets of treatment for this condition. The different treatment plans are as follows:

  1. Proper joint care and rest
  2. Using a cane while walking for taking weight off your hip
  3. Losing excessive weight
  4. Non-drug pain relief measures for controlling pain
  5. Regular exercise
  6. Several medicines, including NSAIDS and other prescribed pain medication
  7. Surgery
  8. Alternative therapies

Hip replacement surgery
This is a surgical procedure used for osteoarthritis treatment when all other treatment plans fail. The damaged ball of the hip joint is replaced with a metal ball in this surgical procedure. The hip socket is resurfaced by using a plastic liner and metal shell. Apart from the mentioned treatment procedures, hip resurfacing is another surgical option for osteoarthritis treatment, which helps in giving relief when a hip replacement surgery is delayed. In this procedure, the affected hip joint surfaces are surgically removed and are replaced with metal. In case you have a concern or query you can always consult an expert & get answers to your questions!

4402 people found this helpful

What Are The Causes Of Hip Osteoarthritis?

Dr. Sanjay Alle 86% (10 ratings)
Diploma In Orthopaedic, MBBS Bachelor of Medicine and Bachelor of Surgery
Orthopedist, Mumbai
What Are The Causes Of Hip Osteoarthritis?

When joints get inflamed, it is known as arthritis. This causes swelling and pain in the joints of your body such as the hips and the knees. When the cartilage gets damaged at the ends of bones, a type of arthritis called osteoarthritis occurs.

There are two main types of osteoarthritis:

  1. Primary: This type is more generalized. It affects the knees, fingers, hips, spine and thumb.
  2. Secondary: This type can occur after injury or joint inflammation, or as a result of any disease that affects the ligament's composition, like hemochromatosis.

How is the hip affected by osteoarthritis?
Patients have difficulties walking if they have hip osteoarthritis. Diagnosing hip osteoarthritis is difficult. It is because the pain appears in varied locations, such as the groin, buttocks, knee or thigh. The pain can be a dull throb or can be sharp and stabbing. The hip is usually stiff.

What are the causes of hip osteoarthritis?

The causes of hip osteoarthritis are unknown. However, the factors that can lead to osteoarthritis are joint injury, excessive weight and rising age.
Along with the abovementioned factors, the following may contribute as well:

  1. The joints may not have developed accurately
  2. The cartilage may have inherited the defects
  3. If the joints are too irritated due to added pressure on them, like excess body weight or stressful activities that include hip movement, osteoarthritis may develop.

What are the symptoms of hip osteoarthritis?
The symptoms of hip osteoarthritis are as follows:

  1. Joints feel stiff when you get out of bed
  2. Joints feel stiff if you have been sitting for some time
  3. The joints feel painful, swollen or tender
  4. You can hear (a "crunching" sound) or feel the bones rubbing against each other.
  5. You find yourself unable to do certain things, like putting on socks, as it requires your hips to move.

How is hip osteoarthritis treated?
The main objective of treatment is to restore the patient's ability to move around. A part of this objective includes correcting the function of the hip and managing the pain. The treatment can include:

  1. Joint care and rest
  2. To take weight off the area affected, a cane is used
  3. Pain relief that does not involve drugs
  4. Shedding excess weight
  5. Exercising
  6. Surgery
  7. Alternative and complementary therapies

Know More About Perthes Disease In Children!

Dr. Ravi C V 88% (15 ratings)
DNB, Fellowship in Pediatric Orthopedics
Orthopedist, Visakhapatnam
Know More About Perthes Disease In Children!

The hip joint is a ball and socket joint made up of the round head of thigh bone (femoral head) with the cup shaped socket (acetabulum) of the pelvis and Perthe’s Disease is an affliction of the hip joints in growing children. It is much more common in boys than girls, and occurs most commonly in children aged between 4 to 10 years. The cause of this problem is still unidentified.

In Perthes disease, changes affect the femoral head which can be seen on X-ray. These changes occur in three stages over 18 months to 2 years:

  1. The blood supply to part of the femoral head is disturbed, causing loss of bone cells.
  2. Softening and collapse of the affected bone
  3. Re-establishment of the blood supply, repair and remodeling of the femoral head.

  • Limping is the most common symptom. The limp may become more persistent and pain may develop. Examination of the child by the orthopaedic surgeon generally shows restriction of hip movement. The nature of Perthes disease is variable. Severity depends on the child’s age, and the extent of femoral head involvement. Older children, girls, and those with greater involvement of the femoral head are likely to require more complex treatment. Treatment aims to reduce pain and stiffness, and prevent femoral head deformity.
  • All children need regular review by the orthopaedic surgeon through the duration of the disease. Not all children require active treatment. Many will make a good recovery with only symptomatic treatment. This may involve restriction of activity such as running and high impact sports. Swimming is encouraged. Some children may require exercise in slings and springs, or the application of plaster casts to the lower limbs. Some children will require surgical management.
  • Children with Perthes Disease are otherwise healthy, but may be affected by physical restrictions. By middle age, one third of those affected have no symptoms, one third have intermittent hip pain, and one third would develop arthritis requiring treatment.

In case you have a concern or query you can always consult an expert & get answers to your questions!

4443 people found this helpful

Know The Procedure Of Hip Replacement Surgery!

Dr. Karan Kishore Mane 84% (10 ratings)
MBBS Bachelor of Medicine and Bachelor of Surgery, MS - Orthopaedics, Diploma in Spine & Reconstruction, Fellowship In Primary Joint Replacement, Fellowship in Arthroplasty and Reconstructive Orthopaedic Surgery, Fellowship in Revision Hip Surgery & Adult Reconstruction
Orthopedist, Nagpur
Know The Procedure Of Hip Replacement Surgery!

Hip replacement surgery is a method wherein a defective hip joint is removed and replaced with an artificial hip joint. This procedure is only opted for after all the other treatments have failed to yield the desired effects. Hip replacement surgery removes damaged or diseased parts of a hip joint and replaces them with new, man-made parts. The goals of this surgery are to:

  • Relieve pain

  • Help the hip joint work better

  • Improve walking and other movements.

Who Should Have Hip Replacement Surgery?

The most common reason for hip replacement is osteoarthritis in the hip joint. Your doctor might also suggest this surgery if you have:

  1. Rheumatoid arthritis (a disease that causes joint pain, stiffness, and swelling)

  2. Osteonecrosis (a disease that causes the bone in joints to die)

  3. Injury of the hip joint

  4. Bone tumors that break down the hip joint.

Your doctor will likely suggest other treatments first, including:

  1. Walking aids, such as a cane

  2. An exercise program

  3. Physical therapy

  4. Medications.

These treatments may decrease hip pain and improve function. Sometimes the pain remains and makes daily activities hard to do. In this case, your doctor may order an x ray to look at the damage to the joint. If the x ray shows damage and your hip joint hurts, you may need a hip replacement.

The Procedure-

Hip replacement surgery is a procedure that can either be performed by traditional means or a minimally invasive procedure. The primary difference between the two procedures is the size of the incision. The procedure begins with the doctor administering local anesthesia, though in certain cases, general anesthesia is also administered.

  1. An incision is then made along the hip and the muscles that are connected to the thigh bone are shifted, so that the hip joint is exposed.

  2. An equipment is then used to remove the ball socket of the joint by cutting the thighbone.

  3. The artificial joint is then fixed to the thighbone and it is allowed to adhere properly.

  4. Once the joint is fixed, the ball of the thighbone is then put in the hip socket.

  5. The fluids from the incision area are then allowed to drain.

  6. The hip muscles are then put in place and the incision is closed.

Post -surgery-

After the surgery, the recovery stage begins. The period of hospital stay post-surgery usually lasts for 4-6 days. A drainage tube is attached to the bladder to get rid of waste products from the body. Physical therapy begins immediately after the surgery and you will be able to walk after a few days with walking aids. The physical therapy continues for a few months after the surgery.

After care-

It is advised to avoid activities that involve twisting your leg for at least half a year. You should also avoid crossing the leg along the mid portion of your body. Your physiotherapist will provide you with exercises that aid to help you recover. Avoid climbing stairs and sit on chairs that have strong back support.

How To Control Hip Joint Pain?

Dr. Karan Kishore Mane 84% (10 ratings)
MBBS Bachelor of Medicine and Bachelor of Surgery, MS - Orthopaedics, Diploma in Spine & Reconstruction, Fellowship In Primary Joint Replacement, Fellowship in Arthroplasty and Reconstructive Orthopaedic Surgery, Fellowship in Revision Hip Surgery & Adult Reconstruction
Orthopedist, Nagpur
How To Control Hip Joint Pain?

Get a diagnosis before anything else. It is really important to know what is causing your pain. See a doctor before you start doing any exercises or taking any medication. There are many reasons your hip could be in pain, including arthritis, bursitis, or an injury you've got while playing a sport. Always ask your doctor what you should and should not be doing, given the cause of your hip pain.

1. Ice your joints: Holding ice to your hips will reduce inflammation of your joints. You should hold an ice pack to the affected area for 15 minutes several times a day. If you find that the ice pack is uncomfortably cold, wrap it in a towel and then place it on the pained area.

2. Heat your joints if you have arthritis in your hips: Heating your joints can soothe the pain you feel. Consider taking a hot bath or shower, or soak in a hot tub if there is one available to you. You could also consider purchasing a hot pad that you can place directly on your hip. Do not use heat to soothe your joints if you have bursitis. Heat can cause hips affected by bursitis to actually become more inflamed.

3. Get some rest: If you have injured your hip, the best thing you can do is to simply give your hip time to heal. Avoid anything that causes you to feel pain in your hip. Instead, grab an ice pack, a bowl of popcorn and watch some movies. You should give your hip a rest for at least 24 to 48 hours.

4. Avoid high-impact activities: If you are in severe pain, chances are you won’t feel like running or jumping anyway, but it is good to keep in mind that these activities should be avoided. High-impact activities will cause your joints to become more inflamed, thus causing your more pain. Instead of running, try taking a brisk walk, as walking has much less of an impact on your joints.

5. Consider losing weight: The more your body weighs, the more weight your painful hip is burdened with supporting. Losing weight can help ease hip pain simply by removing some of that weight that stresses the cartilage and joints.

6. Choose the right shoes: You should buy shoes that give you as much support as possible. Look for shoes that have great cushions, or have removable insoles so that you can add orthopaedics. The sole should have good shock absorption, should limit pronation (turning or rotating the foot) and will evenly distribute pressure along the length of your foot.

In case you have a concern or query you can always consult an expert & get answers to your questions!

4074 people found this helpful

Hip Pain

Dr. Kulwinder Singh Shah 87% (28 ratings)
DNB, MBBS, Fellowship in Joint Replacement
Orthopedist, Zirakpur
Hip Pain

Causes of Hip Pain

These are some of the conditions that commonly cause hip pain:

Arthritis. People with arthritis also feel stiffness and have reduced range of motion in the hip.

Hip fractures. With age, the bones can become weak and brittle. Weakened bones are more likely to break during a fall.

Bursitis. Bursae are sacs of liquid found between tissues such as bone, muscles, and tendons. When bursae get inflamed, they can cause pain.

Tendinitis.  It's usually caused by repetitive stress from overuse.

Muscle or tendon strain. Repeated activities can put strain on the muscles, tendons, and ligaments that support the hips. When they become inflamed due to overuse, they can cause pain and prevent the hip from working normally.

Avascular necrosis .This condition happens when blood flow to the hip bone slows and the bone tissue dies. Although it can affect other bones, avascular necrosis most often happens in the hip. It can be caused by a hip fracture or dislocation, or from the long-term use of high-dose steroids (such as prednisone), among other causes.

Symptoms of Hip Pain

Depending on the condition that's causing your hip pain, you might feel the discomfort in your:

  • Thigh
  • Inside of the hip joint
  • Groin
  • Outside of the hip joint
  • Buttocks

Sometimes pain from other areas of the body, such as the back or groin (from a hernia), can radiate to the hip.

 

 

2 people found this helpful
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