Hip instability is excessive motion of the femoral head (ball) inside, or partially out of, the hip socket.
Hip instability is caused by an injury to, or abnormal laxity of, the ligaments that compose the hip capsule.
Patients will complain of pain in the groin that is worse with activities.
Clinically, the patient will have pain with extension of the hip. Dropping the affected leg off the exam table, will reproduce the patient's pain.
Your physician will prescribe physical therapy, anti-inflammatory medication (NSAIDS), a cortisone injection into the hip joint, and avoidance of activities that reproduce the pain.
For patients that fail non-operative treatment, a procedure to tighten the lining of the joint by sewing it to itself is considered. This can be accomplished either open, or arthroscopically. An alternative method of tightening the lining of the joint is thermal shrinkage of the capsule. By applying heat to the lining of the joint, the surgeon effectively alters the collagen structure of the joint lining. This causes the tissue composing the lining of the joint to contract, tightening the joint.
A hip dislocation occurs when the ball of the hip comes out of the socket. It is considered to be an emergency, because the blood supply to the bone is often kinked as a result of the dislocation. If the bone is without blood for an extended period of time, the bone may die and collapse, leading to severe hip arthritis.
Because the ball and socket joint is quite deep, hip dislocations occur as a result of trauma or collision sports injuries. There is often a fracture of the pelvis associated with it.
Patients will feel a large 'pop' and severe pain. They will be unable to walk.
X-ray will show the ball out of the socket of the hip.
Immediate reduction of the hip joint is accomplished by traction on the leg. Once the hip is back in place, x-rays and a CT scan are obtained to evaluate associated fractures and to be sure that no loose bodies, or bone fragments are interposed in the joint. If the hip is stable, physical therapy is begun to restore range of motion and strength.
An operation is indicated if the dislocation cannot be pulled back into place, an associated fracture of the pelvis makes the hip joint unstable, or bone fragments are stuck in the joint. These fragments will lead to the development of severe hip arthritis, as a result of third body wear, if not removed.
Snapping hip syndrome is the name for conditions that produce an audible 'pop', or 'snap', around the hip joint. There are two main types, internal snapping hip and external snapping hip.
Internal snapping hip syndrome is caused by the psoas, or hip flexor tendon, snapping over the femoral head. External snapping hip syndrome is caused by the tensor fascia lata (upper portion of iliotibial band) snapping over the greater trochanter.
Patients complain of pain over the lateral aspect of the thigh or groin. A snap can be felt and often heard. The patient is usually able to reproduce the snap voluntarily. Symptoms are activity related.
The diagnosis is determined on physical exam and history. The physician will ask the patient to make the snap, and attempt to feel which muscle is causing the problem. X-rays are usually normal, and MRI, at best, will show inflammation in the corresponding area.
Your surgeon will prescribe anti-inflammatory medications and physical therapy to stretch and strengthen the involved muscles.
For internal snapping hip, if conservative treatment fails, your surgeon will lengthen or release the psoas tendon. This can be done arthroscopically, or through an open incision. Lengthening or releasing the tendon will take the tension out of the muscle and keep it from snapping. Patients will have a permanent strength deficit in flexion.For external snapping hip, the surgeon will cut an ellipse out of the tendon, so it can no longer catch on the greater trochanter. The trochanteric bursa is removed at the time of surgery. Cramping and bruising are common post-operative findings.