The femoroacetabular conflict or “impingement” of the hip is considered an abnormal mechanical mechanism in which, during the movement, there is an abnormal contact pressure between the femoral head cartilage and / or acetabular labrum. Usually the symptoms are pain in the lateral region of the hip or groin, less frequently in the posterior region. Recent studies point to the possibility of being a very significant risk factor in the development of osteoarthritis of the hip. Early and appropriate treatment to each case has good results. (see section "femoroacetabular impingement")
In dysplasia there is an abnormal morphology of the acetabular cavity that is smaller than normal and does not completely cover the head of the femur. In this situation there is an eccentric load of the cartilage of the acetabulum and the femoral head that sooner or later leads to the development of osteoarthritis. The symptoms are pain in the lateral region of the hip and groin, which may worsen with prolonged standing position periods. Due to a smaller acetabulum, many patients suffering from hip dysplasia have a higher than normal range of motion.
There is often a constant feeling that the femoral head “is out of place” with symptoms of instability and pain. (see section "Hip Dysplasia")
Septic arthritis of the hip is rare, but can have devastating consequences for the joint. It results from a bacterial infection, within the joint space with formation of pus, rapid destruction of cartilage and spreading to the bone. It is most common in children, elderly patients or other patients whit immune system suppression.(see http://emedicine.medscape.com/article/236299-overview)
The most common disease of the hip joint is osteoarthritis (coxarthrosis). It may have a known cause - secondary osteoarthritis or have an unknown cause - primary osteoarthritis. Typically osteoarthritis is a degenerative process in which the cartilage undergoes wear and cellular transformation that alters its mechanical properties. Wear usually arises as a result of a malfunction of the joint which can be congenital or acquired (some of the diseases described herein can lead to the development of osteoarthritis of the hip).
There is a thinning of the cartilage, with loss of movement and pain. Treatment with physiotherapy can improve these complaints, but usually the definitive treatment is the placement of an inner mechanical prosthesis that replaces the articulation. (see section "Prosthetic reconstructive surgery")
Muscle and tendon injuries
The rebound and hip pain can be caused by periarticular muscle tendons headed to the greater or lesser trochanter. The pain may result from muscle disruptions variable in size. If the rupture is from a large muscle and has significance in the function of the hip there might be indication for surgical repair. Sometimes some situations of anterior rebound are related to adjacent bone deformities as dysplasia and result from an abnormal movement of the iliopsoas muscle.
Aseptic necrosis of the femoral head
The aseptic or avascular necrosis of the femoral head consists of an alteration of the blood flow inside or outside the bone leading to death of bone cells, metabolism alteration of the bone tissue and the development of progressive deformity that almost invariably leads to a process of joint destruction with incidence of pain and motion restriction.
Alcohol consumption, smoking or taking certain medications such as cortisone can be the causes for this vascular change. In a significant number of cases the cause is unknown.
Usually at a later stage of the process of destruction the only treatment is joint replacement by a mechanical prosthesis.
Many patients have a developmental change of the femoral head in which it’s shape looks ovoid. The rotation of this ovoid form triggers an intermittent compression mechanism that can cause injury to the cartilage. In the case of the human hip, simple activities such as moving from standing to sitting can trigger this effect.
Hip dysplasia is caused by a small, sloping acetabulum. It is a frequent condition and sometimes only gives symptoms when there is an important labral injury.. When the hip begins to be painful the treatment should be considered briefly.
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