HIP JOINT

Arthritis

Arthritis of the hip joint is a relatively common condition due to degenerative wear of the articular (joint) cartilage. In some patients the joint can undergo damage due to inflammatory process as in rheumatoid arthritis. This condition can be very painful with patients unable to stand up, walk or do their routine day-to-day tasks and activities. This can result in a severe compromise to the overall quality of life.

Treatment options such as pain killers, physiotherapy can be used initially. However, when the symptoms progress expert input is often essential. Dr Darshan Angadi provides comprehensive treatment options for hip arthritis patients ranging from precise image guided injection therapy to joint replacement surgery using latest evidence-based techniques.

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Avascular necrosis

Avascular Necrosis of the hip (AVN) (also called osteonecrosis of the hip) may be caused by fractures, joint dislocations, excess alcohol consumption, long-term use of steroids, or as the result of certain medical conditions. Rheumatoid arthritis and sickle-cell disease are two conditions that may trigger osteonecrosis of the femoral head, and they may contribute to pain in your hips even when there is no osteonecrosis. This condition can also affect the knee and shoulder joints.

The lack of blood supply causes bone cells of the femoral head to die, possibly ultimately leading to the bone collapse. This loss of blood causes the narrowing of the joint and the collapse of bone. In osteonecrosis, a lack of blood causes bones to decay more quickly than the body can build enough new bone. Breaking the femur, which is the largest bone of the upper leg, or a hip dislocation may impact blood supply to your bones. At the early stages of the disease, there may not be much symptoms. However, as the condition progresses, patients complain of pain and stiffness in affected joints. The absence of blood supply causes a necrosis in the head of the femur, leading to a deformity which puts the patient at a higher risk for osteoarthritis and/or loss of range of motion (ROM).<br><br>
Several treatments are available to help prevent further damage to bones and joints and to lessen pain. Dr Darshan Angadi provides expert care in these cases including core decompression with bone graft/stem cell therapy to help prevent further damage to bones and joints and to lessen pain. In some cases where the disease has progressed and joint salvage is not recommended, total hip replacement surgery is performed to restore function, mobility and provide long term pain relief.

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Cartilage wear damage

Articular cartilage is the layer of material in the hip that covers the surfaces of your femoral head and your acetabulum, cushioning them and allowing them to move over one another without damage. Cartilage can become damaged from sudden trauma, like an athletic injury, or from a process of progressive wear (osteoarthritis). Cartilage and other structures in your hip that are damaged (by an accident or sports injury) can cause further degeneration. All cartilage can be lost, and bone damage can occur, leading to the formation of bone spurs, as well as inflammation in soft tissues.

Patients with cartilage lesions can experience pain, joint stiffness, decreased range of motion, or swelling in affected areas. In serious cases, when a portion of the cartilage breaks or becomes loose, this can interfere with the motion of a joint, or can result in a locked-in feeling of joint, or occasionally the patient may feel the sensation of the joint giving way.
If symptoms like pain, difficulty in weight bearing, inability to walk or disturbed sleep from groin pain are troubling your quality of life the specialist input from Dr Darshan Angadi can help you with prompt diagnosis and treatment options.

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Tendinitis and Snapping hips

In general, individuals who engage in intense, heavy-duty athletic activities involving their hips, such as performing exercises that exceed their bodies tolerance levels, will develop hip tendinitis. Another symptom of the condition is feeling uncomfortable while stretching muscles in the affected hip tendons. Hip tendinitis is most common among athletes like runners, cyclists, ballet dancers, and swimmers, all of whom repeatedly engage similar muscles during the course of their sports.

A sudden injury may trigger hip tendinitis, but it is far more likely that this condition is caused from repeated motion over time. Daily activities such as walking, running, or biking are all causes for hip tendinitis, making everyday activities such as walking extremely painful. Starting a new sport or exercise or trying to ramp up the length or intensity of training too fast may cause hip tendonitis. The primary symptom of hip tendonitis is a slow progression of pain around your hip joints, with no particular injuries.

The most common symptoms are hip pain gradually developing over time. People who have iliopsoas tendinitis usually experience pain on the front side of their hip. When this tendon becomes irritated or inflamed, it can turn into a painful condition known as hip flexor tendinitis, or, more technically, iliopsoas tendinitis. People who have an inflamed or irritated tendon usually feel pain, slight swelling, and tenderness around the affected hip. Hip pain can result from irritation of tendons and muscles surrounding the hip.
Several treatment options are currently available to treat hip tendinitis. Initial treatment is conservative with medications and physiotherapy regimen. However, when symptoms are not fully resolved input from sports injury experts is needed for identification of the triggers for tendinitis. The treatment can then progress to scans, image guided therapies and sometimes surgery to relieve your symptoms.

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Trochanteric bursitis

Trochanteric bursitis is a type of hip pain caused by inflammation in a fluid-filled sac, or bursa, at the external edges of the femur. The external edges of your hip. One of the main causes of hip pain is bursitis, the inflammation of your bursa. Hip bursitis is a painful condition caused by inflammation of a bursa in your hip.

The bursae of the thighs most susceptible to developing bursitis are the trochanteric bursae. Bursitis is when a bursa becomes irritated or inflamed, which typically happens due to an injury or excessive use of a joint. Repeated activities such as climbing stairs or having surgery done on your hip may result in inflammation in this fluid-filled sac. Sedentary or bed-bound patients are also susceptible to thigh bursitis, because the continual pressure on the big trochanter bone at the proximal femur also triggers an inflammatory response of the thigh bursa. For instance, friction may occur as a too-tight iliotibial band (IT band) moves back and forth across the hips trochanteric bursa during knee and hip movements. 

If your outer hip becomes tender and swollen, you might have bursitis on your outer hip. The pain might initially be sharp and sharp, but the pain can later become a pain that extends from the initial pain site down your hip. If your bursa is inflamed, walking and sitting can be extremely painful.
Performing other specific musculoskeletal exams, such as Trendelenberg test and Ober test, may help to identify other structural abnormalities that can cause hip pain laterally. Plain radiography of the hip and femur can be performed to evaluate possible fractures, potential degenerative arthritis, or bony lesions, or inflammation-related deposition of calcium in the area of the large trochanteric bursa (which can be associated with chronic trochanteric bursitis). Therefore, systematic assessment of your hip pain by a specialist is important to guide you regarding the correct treatment and avoid complications.

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Painful or loose hip replacement

The most common issue that may occur with hip replacement is a loosening of the joints. This condition occurs when part of your replaced hip is loose, cracked, or dislocated. A serious infection near an artificial joint can require surgery to remove and replace the hip joint.

Studies have shown the most common causes for hip revisions following a total hip replacement are instability (recurrent dislocation), septic implant wear, and infections. In addition to these risk factors, the most common causes for loosening in a joint replacement are wearing down the surfaces of the implants, and the resulting deterioration of surrounding bone. Knee pain, usually early in the movement, may also be a sign that your implants are loose. Fractures, dislocations, misalignment of components, infections surrounding implants, improper cementing techniques, and some stem designs also contribute to loosening of stem components.
Pain is the most obvious symptom, and early assessment is essential as loose prosthetics may rub against the sockets in the hip, possibly causing further bone loss and making it harder to perform a future surgical repair. Hip pain, groin pain, or hip pain are all signs your hip replacement may be having problems, though other related pains may also be causing your hip pain. Thigh pain or groin pain is a main symptom that the stump is coming loose with hip replacements, particularly when you are walking. Groin pain is characteristic of a pathology of the hip, which can arise from an acetabular issue, while hip pain can be indicative of stem loosening.<br><br>
Regardless of the cause, it may require surgery to repair a surgically-implanted artificial hip or have it replaced with a different type of replacement in order to ease symptoms and allow you to get back to moving freely. If you are experiencing pain in your hip replacement, you might be a candidate for a revision joint replacement. When, as is the case with you, people have pain following hip replacement surgery, an expert input from fellowship trained surgeons like Dr Darshan Angadi is necessary to correctly identify the underlying issue which is diagnosable and can be effectively addressed when treated early as per current scientific evidence-based methods.

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