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HIPS

Hip Anatomy

The hip joint functions as one of the most important joints in the human body. Designed for both mobility and stability, the hip allows the entire lower extremity to move in three planes of motion, while providing an important shock absorption function to the torso and upper body. view 

Hip Contusion

Trauma is the term used to describe injury. Trauma is classified by its severity depending on the amount of force used to cause the injury. view 

Hip Fractures

Hip fractures are breaks in the upper part of the thigh bone (femur) and are the second-most common break in the human body after wrist fractures under the age of 75 years and the most common fracture after 75 years of age. view 

Hip Dislocation

A hip dislocation is classified according to the direction of the dislocation (anterior, posterior, superior, inferior), the amount of force it took to dislocate the hip, whether it is accompanied by a fracture (fracture/dislocation), and whether or not the patient has had a previous hip replacement on the affected side. view 

Thigh Fractures

Thigh bone (femur) fractures usually occur in younger patients after high speed injuries such as motor vehicle and motorcycle accidents. view

Thigh Compartment Syndrome

Compartment syndrome is an orthopedic emergency. Thigh compartment syndrome occurs when the pressure in the front, back, or inner thigh compartments rises above the blood pressure needed for the heart to pump blood to the thigh. view

Hip Arthritis

Hip arthritis is the loss of the cartilage cushion in the joint contact surfaces that normally allows for smooth, pain-free gliding during hip motion. view

Trochanteric Bursitis

A bursa is a fluid-filled sac of tissue that helps tendons slide over themselves as well as over and around bones. view

Hip and Thigh Strain

A hip/thigh strain, by definition, is an injury to a muscle or muscles around the hip and thigh. These injuries can be caused by one specific injury, such as a fall or while playing sports, or by repetitive micro-trauma over time, often referred to as overuse injuries. view

TROCHANTERIC BURSITIS

Pathology

A bursa is a fluid-filled sac of tissue that helps tendons slide over themselves as well as over and around bones. Trochanteric bursitis is inflammation within the bursa that sits on the outer aspect of the hip bone, greater trochanter, and is caused by irritation from the iliotibial band (ITB). The ITB is a thick, canvas-like band of tissue that starts on the outer aspect of the pelvis, runs over the bony part of the hip bone, greater trochanter, and attaches on the upper part of the leg bone, tibia. The ITB can get irritated from running, starting a new aerobic activity/exercise, or from tightness that can develop in the ITB itself. Women are more prone to trochanteric bursitis due to the shape of their pelvis compared to that of men. Trochanteric bursitis often causes pain on the outer aspect of a patient’s hip, that can be worse while sleeping on that side, prolonged sitting, or prolonged activity. The pain on the outer aspect of the hip may or may not run down the outer aspect of a patient’s leg to the knee or upper leg.

 

Treatment

The mainstay of treatment for trochanteric bursitis utilizes non-operative treatment measures. The Iliotibial band (ITB) is usually tight and often the muscles on the outside of the hip and leg are weak. Physical therapy focuses on first increasing the flexibility of the ITB and then strengthening the muscles on the outer aspect of the hip and leg. If the pain is severe, a steroid injection may be recommended to reduce the inflammation within the trochanteric bursa to provide some comfort when performing the exercises in therapy. If an injection is not recommended or deferred by the patient, anti-inflammatory medications will often be prescribed to help reduce the inflammation while the bursitis is being treated.

Rarely, trochanteric bursitis is not fully relieved with the above non-operative treatment measures and surgery is required. The surgery involves, releasing part of the ITB over the hip bone that is tight and removing the inflamed bursa. This procedure is done through a small incision as an outpatient procedure. Physical therapy starts within 3 days after therapy to begin range-of-motion and gentle strengthening exercises. Most patients are able to return to their activities with or without limitations, based on their pre-injury level of ambulation and function.