Hip Surgery

The hip is the connection of the femur, or thighbone, to the pelvis in a ball-and-socket joint. The femur is both held in position and given smooth circular motion with an arrangement of cartilage and tendons. 

Inside the socket of the hip joint, there is a ring of cartilage called the labrum that follows the outer edge of the socket. The labrum acts as a cushion to protect the hip joint, and form a protective seal to keep the top of the femur in place. 

There are also sets of hip joint ligaments connecting the pelvic bone to the bones in the legs. Each of these ligaments stabilize the hip joint and allows it the full range of motion. Similarly, the tendons in the hip connect the muscles around the hip to the femur and pelvic bones. 

There are three main kinds of hip fractures: 

• Femoral neck fracture — making up about half of hip fractures, in which the hip breaks just below the ball of the ball-and-socket joint 
• Intertrochanteric fracture — a break near the top of the hip, where the bone juts in toward the joint 
• Subtrochanteric fracture — an injury lower in the hip and more commonly caused by high-force trauma and found among young men injured in sports 

Hip fractures are usually the result of a fall from a standing position. The patient often has mobility issues at the time, which make the force and damage of the fall all the more significant. 

In the event of less dramatic, stable hairline fractures, the injury may go largely unrecognized, but symptoms include a pain radiating in the area of the groin or the upper thigh. Some stable fractures are not detectable by an X-ray and require an MRI scan. 

Surgery is often recommended so the patient can become mobile again. Without surgery, bed rest and immobility can lead to further problems, especially in the elderly. 

In cases of a stable fracture, an Orthopedic surgeon will often secure the bone and joint with screws. Depending on the severity of the fracture, and age and activity level of the patient, an Orthopedic surgeon may recommend partial or full hip replacement as an option that may be less likely to require more treatment in the future. 

If a patient is in good health, hip fracture surgery often involves an overnight stay in the hospital, followed by a temporary stay in a skilled rehabilitation facility, and then three to four weeks of outpatient rehabilitation. Some patients can go directly home from the hospital if they have enough of a support system. 

While this may result in “functional” recovery, some orthopedic experts recommend continued physical therapy and strength training in the following months to help get the injured hip back to doing most or all pre-fracture activities. Some patients do not get back to their pre-injury level of function after a hip fracture; nevertheless, that is still the goal. 

Over 54 million adults in the United States are estimated to have doctor-diagnosed arthritis, according to the Arthritis Foundation. Although there are dozens of varieties of arthritis, the Orthopedic surgeons of Sauk Prairie Healthcare and around the country primarily see osteoarthritis, avascular necrosis, rheumatoid arthritis, and arthritis due to dysplasia of the hip. 

Rheumatoid arthritis is an autoimmune condition which causes the body’s immune system to attack the lining of a joint, such as the hips, causing swelling and chronic pain.  

Osteoarthritis, or degenerative joint disease, is chronic pain caused by wear and tear of the cartilage between the joints. Osteoarthritis is the most common condition treated by Orthopedic surgeons at Sauk Prairie Healthcare.  

Avascular necrosis (AVN), or osteonecrosis, is a lack of good blood flow to the hip joint, resulting in degeneration. This can occur with no know cause, though the condition has also been connected with use of steroid medication, excessive alcohol consumption, or a previous fracture. 

Dysplasia is a malformation of the shape of the hip that occurs during development. When a person has hip dysplasia the hip socket doesn’t fully cover the ball of the femur, making the joint prone to abnormal forces or instability. These in turn lead to arthritic changes. 

In these cases, a doctor will often begin with conservative treatments to manage pain and reduce swelling, as well as strengthen the supporting muscles with exercise or physical therapy. If conservative treatment is unsuccessful, your Orthopedic surgeon may recommend total hip replacement surgery. 

A hip labral tear is a tear in the ring of cartilage lining the socket of your hip joint. 

Sometimes, hip labral tears display no signs or symptoms. However, when there are symptoms, they can include pain in the hip or groin. Other hip labral tear symptoms include: 

• A locking, clicking or popping sensation 
• Stiffness 
• Limited mobility and range of motion 
• A sensation that the hip is weak or wants to give way when bearing weight 
• Groin pain and less often pain in the side of the hip or buttocks 

Labral tears are often associated with other hip bone issues such as dysplasia and femoracetabular impingement, or FAI. Many times patients notice these conditions by the common symptom of a deep groin pain. 

Labral cartilage can protect the hip from the onset of arthritis in the future. To repair a labral tear, the Orthopedic surgeon will remove the damaged tissue, while leaving healthy cartilage in place. This repair can be done arthroscopically, using small tools guided by a tiny camera through a small incision.

An Orthopedic surgeon will discuss if surgical labral tear treatment is right for you and what options may be available. Physical therapy may also help you strengthen your hip after surgery. 

Hip surgery patients who have received arthroscopic treatment often begin recovery using crutches to get around for the first couple weeks after surgery, but they may require at least 6 weeks without weight-bearing. Multiple weeks of physical therapy are required, and lingering post-operative hip pain can occur over several months. 

Greater Trochanteric Pain Syndrome  

The gluteus medius and gluteus minimus (abductors) are two muscles which can be subject to injuries or stress. This can cause pain on the lateral side or the outside of the hip. These muscles help rotate the thigh bone and keep the hip and pelvis stable when your foot is on the ground.  

This can become more difficult when there is damage to the abductor tendons that connect these muscles to either side of the hip joint. The tendons can become irritated or inflamed, causing pain. Additionally, inflammation of the fluid over the abductor tendons can occur and this is called “trochanteric bursitis.”  

Trochanteric bursitis and trochanteric pain syndrome are common conditions that are often treated with physical therapy and sometimes injections. On rare occasions surgery is performed when non-surgical treatment is not effective. 

Sauk Prairie Healthcare’s Orthopedic surgeons treat a range of hip conditions. Treatment options include less invasive procedures, such as physical therapy, medications, and injections. For the right patients, hip replacement surgery (arthroplasty) has been proven to give significant pain relief and dramatic improvement in quality of life. This can be done with a variety of surgical approaches at Sauk Prairie Healthcare, including the anterior approach. 

Our Orthopedic surgeons are supported by a team of physical therapists, physician assistants, and nurse practitioners who help you get back on your feet again.  

Orthopedic Surgeons: 
Matthew Hebert, MD
Diana Kruse, MD
Michael Lamson, MD
David Marcu, MD
Arnold Rosenthal, MD