The Clinical Center of Friedrichshafen offers the whole scope of modern innovative joint treatment methods. The interdisciplinary approach, experienced specialists and modern equipment are those factors, which allow us to guarantee the accurate diagnostics and safe, efficient joint treatment.
The hip joint is a ball-and-socket joint, which flexibly connects the bones of the femur and pelvis. This means that the joint can move in all directions. It is the most massive joint in a human body, which can carry a lot of weight without any problems. But as the hip joint is constantly under a great load, it is no wonder that its damage heads the list of the articular system diseases.
The hip pain may have different causes. They include injury and inflammatory disease of the tendons and joints, may be manifested by systemic diseases and infectious processes that affect the joint itself or the periarticular anatomical structures. In the event of the hip joint injury, it’s necessary to consult a medical specialist to diagnose and treat the damage immediately.
The human hip joint is subjected to enormous mechanical stress, so it is hardly surprising that joint wear is more common in this joint than in any other joint. Osteoarthritis is what the orthopedist refers to as wearing beyond the age-typical wear state.
The articular surfaces of the hip are covered with cartilage tissue, as a water-storing, elastic tissue, the articular cartilage acts like a sliding pad within the joint. If, in the context of joint wear, the degradation and destruction of these sliding cushions occurs, movements and stresses in the joint trigger pain and restricted movement. The pain picture begins with so-called pain in the beginning, that is pain at the beginning of movements after a rest break, in the further course of the joint wear and tear the people affected with this problem often experience permanent pain in the hip joint.
Cause may be, among other things already suffered in childhood form deviation of the femoral head or the acetabulum, which can then lead to premature wear of the hip joint. Circulatory disorders or inflammatory processes in the hip joint can also lead to osteoarthritis of the hip joint.
Since other diseases, with intact hip joint can cause pain in the groin, a precise delineation of the cause of pain is necessary. In addition to the orthopedic examination, the arthrosis of the hip joint is shown in the radiograph. Here we see the decline of cartilaginous tissue indirectly in a narrowing of the joint space.
The treatment of the joint wear is always under the objective of maintaining the mobility in the joint while increasing the quality of life for the patient. Early and middle stages of joint wear at the hip can be treated without surgery. Especially in the early stages of osteoarthritis, the patient himself can make a decisive contribution to the success of the treatment. Targeted gymnastics serves to maintain joint mobility and muscle strength. The training of joint-gentle movements as well as a weight reduction further contributes to the relief of the hip.
From a middle stage of joint wear and tear a targeted pain therapy, physiotherapy and possibly the use of orthopedic aids is necessary. Since the cartilage tissue can not completely regenerate on its own, we can increase the metabolic processes in the joint through various physical processes and thus promote cartilage regeneration. Two modern methods are Magnetic Field Therapy and Magnetic Resonance Therapy. Furthermore, cartilage-supporting agents such as hyaluronic acid can be injected directly into the joint by injection therapy. Even in the middle stage, physiotherapy plays a crucial role. Orthopedic aids, such as special shoe straightening and crutches, can aid the treatment.
There are the diseases, having the nontraumatic origin, as osteoarthritis, osteoarthrosis, infectious hip arthrosis, blood supply disturbance of the bones that form the joint, which cause the joint pains. The degenerative changes in the joint surfaces (pathological changes in the joint synovial membrane, damage of the cartilage, the periarticular structures damages, decrease of the joint fluid amount) cause the complications of these diseases, which lead to the pain syndrome and joint dysfunction.
Coxarthrosis is a wear of the hip joint. The hip osteoarthritis occurs especially in older people. In the x-ray you can see how much osteoarthritis has changed the hip joint and adjacent bone structures. In extreme cases, the joint must be replaced by a prosthesis. Coxarthrosis is a common disease in Germany, whose risk increases with age. In certain pre-existing conditions, however, arthrosis in the hip can occur even in very younger people. Attention: Even if the X-ray shows a hip joint arthrosis, the patient does not necessarily have discomfort. Then there is a purely radiological (ie X-ray) visible hip osteoarthritis.
The case is different for a clinically defined hip osteoarthritis. It shows clear signs of wear in imaging and causes pain to those affected.
Hip and hip joint can be damaged by various diseases. In some cases, a hip osteoarthritis then develops. These possible triggers of coxarthrosis include bone fracture, inflammation and inflammatory joint disease and metabolic diseases. Coxarthrosis often develops even with a deformed hip. The femoral head is not located correctly in the acetabulum. This is the case with hip dysplasia (malformation of the hip joint), Morbus Perthes and Epiphyseolysis capitis femoris. These diseases already exist at birth or occur in childhood or adolescence. But they often lead to a hip joint arthrosis only many years later.
As hip dysplasia, doctors refer to a congenital or acquired malformation of the acetabular cup. It occurs in about two to three out of 100 newborns, especially in girls. If left untreated, hip dysplasia can result in permanent damage to the femoral head or socket. A later disability and premature signs of wear are the possible consequences.
Unrecognized or late-treated hip dysplasia in babies severely restricts mobility later in life and can cause pain in adolescents. Premature wear-related changes can occur, which can limit the choice of career and may lead to early disability. Malformations of the hip joint, such as hip dysplasia, promote early joint wear (osteoarthritis).
Osteoporosis (bone loss) is one of the most important common diseases. In Germany, millions of people suffer from it, especially older women. In those affected, the bone substance builds increasingly degraded. This makes the bones increasingly unstable and brittle.
The bones, also in the hip joint, are constantly being rebuilt to be adapted to changing requirements. By about the age of 35, more bone mass is generally built up than mined. From the age of 35, the bone is gradually outgrown and accelerates with age. Healthy older people lose around 0.5 to 1 percent of their bone mass every year.
This normal bone metabolism can be disturbed by a variety of influences. For example, calcium deficiency, lack of exercise and hormone-related diseases can inhibit bone formation and / or promote bone resorption. As a result, bone mass disappears - it causes osteoporosis. Mainly affected are older people. In extreme cases, patients can lose up to six percent of their bone mass every year!
In a hip joint dislocation bones jump jerky from their joints - usually by a fall or an extreme force. A dislocation is usually extremely painful and the ability to move then severely restricted. Under general anesthesia, the surgeon can manually reposition the joint, but sometimes surgery is required.
Osteoarthritis starts to develop when the load the hip joint has to take exceeds the load it can take. In the process, cartilage tissue is destroyed progressively. The damage is irreversible as cartilage tissue cannot be regenerated. Ultimately, the bones rub over each other without protection and the joint surfaces enlarge and become deformed. From this arise inflammation and, paralleling the progressive deformation of the joint, increasing tenseness of the muscles, restriction of motion, swelling, and pain.
The breakdown of the layer of cartilage between the femoral head and the socket of hip as we get older is called “age-related” degeneration. The hip joint is damaged to such an extent that it can no longer perform its function as a “shock absorber.”
The medical term, hip dysplasia, describes a deformity of the hip socket which is present from birth. The femoral head should sit in the shadow socket of the hip (the acetabulum). If the socket is too flat in shape and at a sharp angle, the femoral head is only covered by part of the socket, then the joint undergoes excessive strain. If left untreated, this malposition of the hip joint can lead to osteoarthritis at an early age. However, modern examination procedures ensure that hip dysplasia is diagnosed early.
Fractures and avascular necrosis of the femoral head are the most dangerous (however, not the most frequent) causes of the hip pain.
Trauma and falls can lead to fracture of the neck of the femur meaning that the femoral bone breaks at its neck, just next to the hip joint. The risk of bone fracture increases significantly with increasing age and reduced bone substance. Consequently, it is often elderly patients who are afflicted by these fractures. If blood vessels supplying the bone with blood are damaged, the head of femur can die (femoral head necrosis). In such cases an operation is necessary. An artificial hip joint is often implanted during this operation.
The femoral bone fracture (especially its neck - the narrowest part) is a bad problem, especially for older people. As a result, it significantly reduces man’s activity, and older people frequently have severe complications during the recovery period (thrombosis, infections, etc.). The risk of the fracture increases with age and especially for the patients suffering from osteoporosis (the decrease of the density and strength of the bone).
The avascular necrosis of the femoral head is the death and destruction of the femoral bone joint occurred as a result of the cessation of blood supply to it. This condition may have complications if taking glucocorticoid (hormonal) drugs, in the event of antiphospholipid thrombosis and other diseases.
The hip dislocation is rather infrequent injury. These are usually inside automobile injuries, when the traumatic forces act along the axis of the leg bent at the knee and a body is fixed, and injuries caused by the fall from a height.
There are posterior (90% of all the dislocations), anterosuperior and anteroinferior dislocations.
When the dislocation is posterior, the leg is bent at the hip and knee joints and is set and rotated inwards; when it is anterosuperior, the leg is straightened, taken aside a bit and rotated outwards, and the femoral head is felt below the femoral (inguinal) arch; in case of anteroinferior dislocation, the leg is bent at the hip, taken aside and rotated outwards.
Since different diseases may cause the hip joint pain, it is necessary to conduct a thorough differential diagnosis of each case. The following methods of the examinations give especially valuable information:
The treatment is selected only after thorough diagnostics and consultation. To reduce pain in the hip joint, there are many different treatment options. The success of either option depends not only on the condition of the hip joint of each individual, but also on the professionalism of the joint specialist. In order to relieve the arthritis pain the complex combination treatment is needed, which should be tailored to the individual needs. To choose the best method of treatment, you should consult the specialist at Friedrichshafen. In some cases the hip replacement surgery could be the key. Hip replacement recovery usually lasts a month or two. After it many patients forget about the hip pain.
The doctors of Friedrichshafen clinic of fully use all their opportunities to help their patients, suffering from the pain syndrome in the hip joint, most effectively. The treatment regimen is selected for each patient individually that helps to cope with sciatica and all other manifestations of the diseases completely in the shortest possible time.
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