Diseases of the Hip & Knee


Arthritis

If you suffer from arthritis of the hip or knee, you know what a toll it can take on your quality of life.  The pain and stiffness may lead to difficulty with more vigorous activities like exercising, golfing, hiking, and strenuous household chores like yard work to more day-to-day activities like climbing stairs, shopping, even dressing and bathing.   Some individuals that live with arthritis of the hip or knee (or their spouses, friends or co-workers) notice that they limp or even develop deformity of the leg, bowing inward or outward.  Others notice instability, the feeling that they don’t trust their leg in certain situations, or weakness, particularly arising from a chair or on stairs.  Another common complaint is difficulty getting going after sitting for a period of time.

Most people that have arthritis of the hip or knee are able to maintain their desired quality of life with conservative measures such as modifying their lifestyle, judicious use of medications, strengthening and flexibility exercises and occasionally braces or injections.  For those that cannot achieve the quality of like that they want or need, hip and knee replacement surgery may be an option.  More so than ever, surgery to replace a worn out hip or knee has a high success rate, and is performed in a less invasive manner, affording a quicker and easier recovery than in the past (see Joint Replacement Section for more detail).


Avascular Necrosis (AVN)

AVN most commonly affects the hip, but at times it can involve the knee.  It can affect people of all ages and often occurs in younger individuals.  AVN can be the result of an injury.  It can also occur with diseases such as Lupus or use of medications like prednisone to treat other conditions.  At times, the cause of AVN is not easily identifiable.  Regardless of the cause, AVN can rob quality of life by leading symptoms similar to arthritis, mostly pain and stiffness, occasionally instability and giving way.  AVN is usually diagnosed with an MRI however late stages can sometimes cause changes visible on plain x-rays.

AVN occurs when an area of bone in the hip or knee dies (similar to a heart attack) due to lack of blood supply.  The event when the bone dies is painful.  In some individuals, the amount of bone that dies is small, and the body heals the area with little long term problems, other than possibly an abnormal appearance of the bone on x-ray or MRI.  In these situations, treatment is often not needed.  At other times, when a larger area of bone is affected, arthritis sets in, and pain and stiffness (and other symptoms) can become chronic, and quality of life can deteriorate.

When this occurs, there are options that the Physicians in the Hip and Knee Section at Fondren Orthopedic Group can discuss with you.  There may be conservative options like exercises, physical therapy or medications.  At times, joint replacement surgery is an option to regain quality of life and the ability to resume the activity level you desire (see Joint Replacement Section for more detail).


Leg-Calve-Perthes Disease

Leg-Calve-Perthes (LCP), sometimes referred to as Perthes disease, occurs in childhood, but can cause problems that persist into adulthood.  LCP is caused by lack of blood supply to the hip ball (femoral head).  In children who can develop Perthes as early as age 4, parents may notice their child limping or complaining of pain coming from their hip, which may be felt the groin or buttock area, or on the side of the hip.  Children with problems in their hips sometimes even have pain in their knee, which is referred from their hip.  The Pediatric Orthopedists at Fondren Orthopedic Group can discuss management options for this problem.

Perthes in childhood can heal, leaving the hip ball (femoral head) with a less than optimal shape, more mushroom shaped than round, which can cause stiffness and even lead to arthritis in adulthood.  Management of these problems can be discussed with the Joint Replacement Specialists at Fondren Orthopedic Group.


Hip Dysplasia

Hip dysplasia, a shallow or mal-oriented hip socket, which usually occurs with an abnormally shaped hip ball, is often present at birth.  If your pediatrician feels that your child may have hip dysplasia based on their examination, they may refer your child to a Pediatric Orthopedist for further evaluation.  The Children’s Orthopedists at Fondren can examine your child, and will possibly order an ultrasound or x-rays, and will determine the best course of management.  If hip dysplasia is not treated in infancy, it is more likely that problems with the hip later in life may develop.

Adults with hip dysplasia are at greater risk for developing torn cartilage in the hip (“a labral tear”, see below) and premature arthritis.  Occasionally, young women who develop hip pain as teenagers or young adults may discover that they have hip dysplasia.  Often, pain in an individual with hip dysplasia can be managed conservatively.  The Joint Replacement Specialists at Fondren can help to develop the best treatment strategy when lifestyle is affected.


Labral Tears and Hip Impingement

Labral tears in the hip can cause hip pain that is usually felt in the groin, buttock or side of the hip.  They may also cause bothersome popping, catching or locking.  More often than not, labral tears occur in individuals with a structural abnormality in their hip such as hip dysplasia, or an overly deep hip socket.   Impingement, or banging together of the two bones of the hip socket can lead to labral tears.  This impingement may happen because of an abnormal hip structure, or repetitive twisting movements such as dance, golf, soccer or other similar activities.   Labral tears may also result from injuries such as a car wreck or a forceful sports injury or dance or gymnastic move.  Specialists in Fondren Orthopedic Group evaluate and treat labral tears and hip impingement.

If you would like your symptoms diagnosed or evaluated, or would like to explore our treatment options for these debilitating conditions, contact one of our physicians at a location near you.

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