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Hip Pain and Replacement

Hip Pain & Replacement by Dr. Derrick Lousaing

The majority of patients presenting with complaints of hip pain seem to have varying ideas on where anatomically their hip actually is. A significant percentage of patients point to areas related but not necessarily anatomically the hip. These areas include the lower back, the lower buttocks, the back of the thigh, and the lower abdomen which all suggests that this is their interpretation of the anatomical location of the hip joint.

Anatomically, the hip consists of a deep socket with a ball attached to the proximal end of the thigh bone whicharticulates together. The range of motion of the hip is usually quite extensive. For patients who have true hip joint pain it is usually as a result of damage, irregularity to the gliding surface of the joint or inflammatory responses to the capsule of the joint. This is broadly defined as arthritis. The underlying cause can be degenerative or aging arthritis, inflammatory arthritis or posttraumatic from previous injury. Less commonly do we see is what can be described as combined arthritic disease (CAD) which includes both degenerative and an inflammatory component. Hip pain results in several aspects of limitation in activities of daily living and these cues in the interview with your doctor can indicate whether there is true hip pain or not.

With pain coming from the ball and socket joint, there is usually limitations of deep flexion at the hip, which causes difficulty with low seats, car access, cleaning and toileting and dressing of the toes, feet and ankles, the ability to put underwear on, sock application, tying of shoelaces and difficulty with stairs. When the process has been going on for some time, the limitation of function becomes more consistent. Notably, the patient will develop a limp, which in medical terms can be described an antalgic or Trendelenburg gait and a feeling (real or apparent) that the limb has become shortened on the affected side.