Do You Have Hip Pain?
Hip pain can have many causes and can also be felt in many different places. The hip is a dynamic structure with many potential pain generators.
Front of the Hip (Anterior/Groin)
Anterior hip pain is the most common area to experience true hip joint pain. Pain in the front of the hip could potentially be a groin strain acutely. Chronic groin pain particularly with sitting can be caused by a labral tear and/or impingement.
The labrum is a ring of cartilage around the rim of the hip socket. It functions like a seal to seal the head of the femur in the socket.
The labrum can tear. Unfortunately when it tears it will rarely heal. There are nerves in the labrum that, if torn, cause pain. Following a labral tear, the contact forces across the hip increase significantly causing pain and potential joint degeneration as well. Surgery is often recommended for the pain and also to restore proper hip function for joint preservation. Labral Repairs are recommended in Hip Preservation surgery. Labral Debridement should only be performed if the labrum is irreparable.
Side of the Hip
Often times the side of the hip can be tender. The good news is tenderness alone can often be treated without surgery. The most common cause of lateral hip pain is bursitis. Bursitis can often be treated with medication, injection and physical therapy. If bursitis continues a Bursectomy can be performed arthroscopically.
Bursectomy means to remove the bursa. The bursa of the hip can be removed through 2-3 small poke hole incisions. The IT band is a long tendon along the side of the hip that can be split and slightly lengthened. This is typically the cause of bursitis. The bursa can then be removed. The procedure is a minimally invasive outpatient procedure that takes approximately 20-30 minutes.
Back of the Hip (Posterior)
Often times buttock pain is related to lumbar spine issues like sciatica. However, particularly in elderly patients gluteus tears can occur.
In patients with chronic buttock pain and/or a limp. The gluteus tendons can tear particularly the gluteus medius tendon. These tears can cause chronic buttock pain, limping and weakness. These tendons have to be repaired to heal. Gluteus medius repair can be performed arthroscopically.
Gluteus Medius Repair
The gluteus medius tendon can be repaired arthroscopically as an outpatient procedure. The surgery is performed with 3-4 small poke hole incisions. The tendon is repaired back to the bone utilizing sutures and nonmetallic anchors with the use of a small camera. This procedure is most common in elderly patients with buttock or outer hip pain.