The hip joint is one of the most load-bearing joints of the body. There are two bone structures (femoral head and acetabulum) that make up the joint, and there is a 4-5 mm thick cartilage structure at the ends of these bones forming the joint. In addition, the joint fluid (synovial fluid) that provides nutrition for the hip is effective in the nutrition of the cartilages. Hip gliding movement takes place over these cartilage structures and painlessly. After pathologies that cause deterioration of the cartilage structure, hip joint calcification (coxarthrosis), also known as “fluid loss” among the people, is observed in the knee.
The most common cause of hip joint calcification is “Primary Osteoarthritis”, the cause of which is unknown, but caused by various reasons or a combination of these. In this disease, articular cartilage deterioration occurs after the formation of substances that damage the cartilage in the synovial fluid in advanced ages. Apart from this, cartilage deterioration due to various reasons, called “secondary (secondary) osteoarthritis”, is also observed. These causes include trauma, congenital hip dislocation sequelae, previous fractures of joint structures, previous hip joint infection sequelae, rheumatic diseases and compression between the structures forming the hip joint. (Femora-acetabular impingement syndrome-FAI)countable.
Patients often present to the orthopedic outpatient clinic with pain intensifying around the hip joint, decreased hip movements, and limping. In the early stages of the disease, the pain occurs when walking long distances and going up and down many stairs, but as the disease progresses, it starts as soon as the patient starts walking and can reach a level that wakes him up at night. The amount of hip joint movement decreases over time due to pain. Until the final stage, many patients undergo rehabilitation, hip injections, PRP treatment and/or closed hip joint surgeries.
After taking a detailed disease history by an orthopedist, the patients are evaluated with special examination techniques for the hip joint. After the preliminary diagnosis is made after the examination, x-rays of the pelvis and frog position, waist x-rays and “orthorentgenography” showing the lower part of the waist in a single x-ray can be requested. In osteoarthritis patients, the closure of the joint space, the observation of bone protrusions called “osteophytes” and the observation of tiny cysts under the cartilage make the diagnosis.
Treatment is shaped according to the stages of the disease in patients. Weight loss, rehabilitation, device support, intra-hip injections in the very early stages (Cortisone, PRP) applicable non-surgical treatment methods. Surgical methods vary according to the cause and stage of the disease. hip joint impingement syndrome (Femoracetabular Impingement Syndrome-FAI)In order to reduce the risk of calcification and eliminate complaints in patients with hip arthroscopy (joint surgery with closed method) can be performed. If hip joint deterioration has not started in young patients with acetabular socket failure, which is a mild form of congenital hip dislocation. “Pelvis rotational osteotomy” So-called socket turning surgery, which both reduces pain and delays the prosthesis, can be applied. In patients with advanced calcification and involvement of the entire hip, “Total hip replacement”It provides permanent comfort to patients.
In hip prosthesis, after reaching the joint line with incisions (front, lateral or posterior intervention) of the hip joint, which may differ according to the surgeon’s preference, the damaged ends of the bones forming the joint are cut and implants made of metal alloy (Cr-Co-Mo), ceramic or thick polyethylene with the help of special sets. with the new joint line is created. Complications include post-surgical infection, clot formation (embolism) and vascular injury, which can be seen very rarely. Patients are carried out with support one day later. Physical therapy, which is started in the early period after surgery, has a positive effect on the surgical outcome.
What complaints are seen?
Pain, often concentrated around the hip joint,
Decreased hip movements and limping,
The amount of hip joint movement decreases over time due to pain.