KV Healthcare

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Hip

Joint conditions like arthritis can lead to cartilage and bone damage, resulting in chronic hip pain and disability. Treatment often involves replacing the affected areas with artificial components. Dr. Longo offers expert diagnosis and hip replacement surgery in Ellensburg, WA, along with personalized care throughout the surgical process and recovery. Schedule an appointment with KVH Orthopedics!

Hip Conditions

Hip Fracture

A hip fracture is a break in the upper femur, near the hip joint.

Causes

  • Weak bones in the elderly after minor trauma
  • High-energy trauma in younger people
  • Certain medications increase risk

Symptoms

  • Pain in the groin or outer thigh
  • Swelling, tenderness, and leg shortening

Diagnosis

  • X-ray, possibly MRI

Treatment

  • Non-surgical: Traction to align bones
  • Surgical: Fixation with plates, screws, or rods

Hip Pain

Hip pain is a common complaint, often felt around the hip joint rather than directly over it. The exact location of the pain can help identify the underlying cause.

Causes of Hip Pain

  • Groin or hip joint pain: Often due to issues within the hip joint itself.
  • Outer hip, thigh, or buttock pain: May result from problems with muscles, ligaments, tendons, or surrounding soft tissues.
  • Conditions like lower back or knee issues can also cause hip pain.

Common causes include

  • Hip fractures (especially in the elderly)
  • Arthritis
  • Bursitis
  • Infections
  • Osteonecrosis (loss of blood flow to the hip)
  • Sprains, strains, or tendinitis

Diagnosis

Doctors assess hip pain through medical history, physical exams, and diagnostic tests like X-rays and scans.

Treatments

  • Self-care: Anti-inflammatory medications and avoiding activities that worsen pain.
  • Physical therapy: Stretching and warm-up exercises for muscle relief.
  • Ice packs: Apply for 15 minutes, 3-4 times a day to reduce pain and swelling.
  • Severe cases: Consult an orthopedic provider for proper treatment.
Hip Dislocation

Hip dislocation occurs when the femoral head moves out of the hip socket, either backward (posterior) or forward (anterior).

Causes

  • Motor vehicle accidents
  • Severe falls

Symptoms

  • Pain, inability to move the leg
  • Numbness in the foot or ankle
  • Possible fractures

Diagnosis

  • Physical exam and X-rays

Treatment

  • Reduction: Repositioning the bones under anesthesia
  • Surgery: To remove fragments or torn tissues
  • Recovery: Use crutches and physical therapy

Hip Stress Fractures

Stress fractures of the hip are small cracks in the femur, typically occurring just below the hip’s ball-and-socket joint, known as the femoral neck. These fractures are common in athletes like distance runners, ballet dancers, and those involved in high-impact activities.

Causes

  • Repetitive trauma or overuse of the hip
  • Sudden increase in activity level
  • Poor nutrition, low energy intake, or low BMI

Symptoms

  • Groin pain that worsens with activity
  • Aching pain in the groin, relieved by rest

Complications if untreated

  • Complete femoral bone break
  • Dislocation, weakening, or death of the femoral bone
  • Hip osteonecrosis (lack of blood supply)

Diagnosis

  • X-rays, followed by an MRI or bone scan if needed

Treatment

  • Rest and activity modification
  • Crutches or complete rest for severe cases
  • Surgery if the fracture is significant

Prevention

  • Choose low-impact activities
  • Strengthen hip muscles through exercise
  • Ensure adequate intake of calcium and vitamin D

Hip Procedures

Total Hip Replacement

Hip replacement surgery involves replacing part or all of the hip joint with artificial components (prosthetics). The hip is a ball-and-socket joint, where the thigh bone’s ball fits into the pelvic socket. When damaged, the hip becomes painful, stiff, and less mobile.

Conditions Leading to Hip Replacement, common causes include:

  • Osteoarthritis: The most common cause, often related to aging
  • Other types of arthritis, such as rheumatoid arthritis
  • Congenital hip issues or injuries

When is hip replacement recommended?

Doctors typically try treatments like weight loss, medications, physical therapy, and assistive devices before recommending surgery. Hip replacements usually last 15+ years, but they can wear out over time, especially in younger, more active individuals

What happens during hip replacement surgery?

Hip replacement is performed under anesthesia. The surgeon makes an incision, removes the damaged joint, and replaces it with an artificial prosthesis made of metal, plastic, or ceramic.

What happens during hip replacement surgery?

After surgery, patients typically stay in the hospital for 2-4 days. Care includes:

  • Pain management and antibiotics to prevent infection
  • Blood clot prevention (special boots or stockings)
  • Physical therapy, where patients usually begin standing and walking within a day. Exercises focus on strengthening muscles and improving mobility, including bending, walking, and climbing stairs.

Hip Fracture Surgery

Hip fracture surgery is performed to treat breaks in the upper femur, near the hip joint. This is common in the elderly and can result from trauma or weakened bones.

Causes

Hip fractures are often caused by minor trauma in the elderly due to weak bones or by high-energy injuries in younger people. Long-term use of certain medications, such as those for osteoporosis, can also increase the risk.

Symptoms

Common symptoms of hip fractures include pain in the groin or outer thigh, swelling, leg shortening, and difficulty rotating the hip.

Diagnosis

A hip fracture is diagnosed through a physical examination and imaging tests such as X-rays, MRIs, or bone scans.

Preoperative Assessment

Before surgery, a health evaluation is conducted to ensure you are fit for the procedure. Anesthesia options are discussed, and you may receive antibiotics to prevent infection and anticoagulants to reduce the risk of blood clots. Blood tests and other evaluations may also be performed.

Surgical Options

  • Total Hip Replacement: Replaces both the femoral head and acetabulum.
  • Partial Hip Replacement: Replaces only the femoral head.
  • Internal Fixation: Uses screws, plates, or rods to stabilize the bone while it heals.

Postoperative Care

Post-surgery care includes using assistive devices like crutches or splints, elevating the leg, and taking medications to manage pain. Physiotherapy is recommended to improve strength, flexibility, and mobility.

Risks

Potential risks include infection, nerve damage, blood clots, leg length discrepancies, and muscle atrophy.

Benefits

Successful hip fracture surgery offers pain relief, improved mobility, increased strength, and an enhanced quality of life.

Hip Surgery

Hip surgery treats injuries or conditions in the hip joint by repairing damaged structures to relieve pain and restore function. The hip joint connects the femur (thighbone) and pelvis (acetabulum) and can require surgery if damaged.

Indications for Surgery

A hip fracture is diagnosed through a physical examination and imaging tests such as X-rays, MRIs, or bone scans.

  • Total Hip Replacement: Replaces both the femoral head and acetabulum.
  • Arthritis (cartilage degeneration)
  • Femoroacetabular impingement (bone friction)
  • Hip dislocation or fracture
  • Hip dysplasia (shallow acetabulum)
  • Labral tear or avascular necrosis (bone death)

Preparation

Before surgery, you’ll undergo a medical exam, blood tests, and imaging. You may need to stop certain medications and arrange transportation home. A consent form will be signed once the procedure is explained.

Procedure

Hip surgery can be done arthroscopically (minimally invasive) or through open surgery. Common procedures include:

  • Labrum Repair/ Reconstruction: Fixing or replacing the cartilage around the hip socket.
  • Femoral Osteoplasty: Removing bone to treat impingement.
  • Total Hip Replacement: Replacing the damaged hip joint with prosthetics.

Postoperative Care

Recovery includes pain management, crutch use, and limited activity. Physical therapy helps restore function, and follow-up appointments monitor progress. Full recovery may take up to 6 months.

Risks

Potential risks include infection, bleeding, nerve damage, blood clots, joint instability, and hardware failure. Most can return to normal activities within 3–4 weeks, but sports may require up to 6 months.

Physical Therapy for Hip

Physical therapy is an exercise program designed to improve movement, reduce pain, promote healing, and restore physical function. It helps with daily activities like walking, getting in and out of bed, and climbing stairs. Often prescribed after surgery, injury, or chronic conditions like arthritis, physical therapy can be tailored to individual needs or combined with other treatments.

Physical therapy includes education, manual therapy, exercises, and various techniques. These may include:

  • Stretching Exercises: To improve flexibility and restore joint and muscle movement, especially for conditions like arthritis or after surgery.
  • Core Strengthening: Exercises that target the pelvis and lower back to support the body.
  • Ice and Heat Therapy: Heat reduces pain and muscle spasms, while cold therapy helps with swelling and injuries like sprains.
  • Ultrasound: High-frequency sound waves stimulate deep tissues to improve blood flow and aid healing.
  • Electrostimulation: Electric currents relieve pain, stimulate muscles, and expand blood vessels.
  • These treatments may cause mild soreness or swelling, but you should consult your therapist if symptoms persist.

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