Our hip is a ball-socket joint. The round head of the femur fits snugly into the socket-like cavity of the pelvis (acetabulum). Normally, the head of the femur slides easily in all directions within the socket. Some problems with this ball-socket mechanism can disrupt the fluidity of the movement. The cartilage tissue at the edge of the pit can be damaged as a result of excessive movements that involve bending (flexion) of the hip. In this case, a problem called hip impingement or femoro-acetabular impingement (FAI) may occur. Hip impingement syndrome is one of the causes of hip calcification (osteoarthritis) that occurs earlier than the age of 40.
Hip Impingement Symptoms
Hip impingement exists for a long time without causing pain. it could be. When it causes pain, it is called hip impingement syndrome. Pain occurs in the front part of the hip, in the groin, especially when walking and when the hip is flexed. Pain in the side of the hip and thigh area is rare. The normal range of motion of the hip joint is reduced. Initially, pain occurs only when the hip approaches the limit of its normal range of motion, for example when it is bent too much. As the problem progresses, it may cause pain in daily activities such as sitting for long periods of time and climbing uphill. Continuing pain while walking on a flat road and at night indicates that the cartilage tissue in the joint is damaged and lost in places. Eventually, osteoarthritis, also known as joint calcification, may develop.
Symptoms of hip impingement may have an insidious onset that increases over time due to overuse, or may appear suddenly after an acute injury.
Hip. Why Does Hip Impingement Occur?
Hip impingement may occur due to two main reasons, depending on whether the problem is in the thigh bone (ball part) or the pelvis (socket part).
Thigh bone (femur) ) compression due to deformity in the head is called "glass type". If the femoral head, which normally has a smooth sphere-like shape, is not straight, the abnormal part gets stuck on the edge of the socket during movements where the hip is flexed, such as tying shoes or pedaling. It is more common in young men.
The compression caused by the problem in the acetabulum, which is the pit of the pelvis, is called "pincer type". It is called "i". If the front edge of the acetabulum is longer than it should be, the neck of the femur may hit here when the hip is bent and cause compression. It is more common in middle-aged women.
Sometimes, there may be problems in both the pelvis and thigh bone. This is called mixed type.
Hip impingement may occur due to overly challenging activities of athletes on the basis of developmentally existing slight irregularities in the joint surfaces mentioned above.
There are also other problems that can cause hip impingement. In Legg-Calve-Perthes disease, the femoral head cannot be adequately nourished due to circulatory problems and the bone tissue dies. Bone deformity occurs. The problem called slipped capital femoral epiphysis is a condition characterized by the separation of the femoral head from the growth cartilage in adolescence. "Coxa vara" is another cause of hip impingement syndrome in children, which is characterized by a decrease in the femoral neck angle as a result of the growth cartilages of the femur working at different speeds.
How is Hip Impingement Diagnosed?
First of all, complaints are questioned. During physical examination, hip joint movements are measured. In the hip impingement test, flexion-adduction and internal rotation movements are performed on the hip and it is checked whether complaints occur.
X-ray films show the alignment and shape of the bones. Hip joint MRI (MRI) can show in detail soft tissues and bone edema, including the cartilage framework (labrum) surrounding the acetabulum. Computed tomography provides detailed three-dimensional imaging of bones.
PHYSIOTHERAPY
The first step in treatment is rest and reducing activities that cause pain. Then, exercises are recommended to stretch and strengthen the muscles around the hip WITH PHYSIOTHERAPY. During the painful period, painkillers can be used for a short time.
With hip joint mobilization, tense tissues such as joint capsule and muscle can be stretched. Exercises that increase joint position sense and dynamic control of the hip may be useful.
Physical therapy methods such as TENS and ultrasound can be used to reduce pain and increase joint range of motion.
Repair of cartilage damage. Regenerative medicine methods such as stem cell and PRP injection are increasingly used for treatment.
If improvement cannot be achieved with physical therapy, surgery may be on the agenda. Which surgery will be performed is determined by the physician according to the type of compression and the damage to the cartilage tissue. If the problem has not progressed, it can be treated with closed (arthroscopic) surgery. If there is extensive damage to the cartilage and if joint calcification is advanced, hip joint prosthesis surgery may be required.
Physical therapy is very important to return to normal life after surgery.
Read: 0
