The hip is a ball and socket joint (shown in video). The ball is formed by the head of the femur (thigh bone) and the socket is called the acetabulum, which is part of the pelvis. Each joint surface is covered by a layer of cartilage called articular cartilage. From an anatomic standpoint the hip joint has sacrificed less mobility in exchange for more stability compared to another ball and socket joint – the shoulder, which is not a weight bearing joint. A deep socket is what allows the hip joint to be more stable so it can serve one of its major functions - weight bearing. Around the outer edge of the acetabulum there is a rim of cartilage that allows the socket to be even deeper (Imagine a race track with very high banked curves). This cartilage socket rim is called the acetabular labrum. There are large and powerful muscles that attach via tendons in the region around the hip joint. They collectively add further stability to the hip joint, but more importantly allows us to walk, run and climb. A “sack” called a bursa is strategically positioned in various locations to provide lubrication to all of these tendons. The most prominent bursa is the trochanteric bursa on the outside (lateral) aspect of the hip girdle. Hip problems and low back problems often overlap because both regions share muscles that connect them.
As a result of the hip joint’s weight bearing responsibilities, degenerative osteoarthritis (shown in video) changes are common in this joint as a person ages. During the growing years of a person life, bone deposits can accumulate in locations that can later cause pinching between the femur and the acetabulum during motion of the joint. This condition is known as femoroacetabular impingement (FAI) and can result in pain as well as mechanical damage to the acetabular labrum. The tendons that connect the large locomotion muscles to the hip girdle can develop tendinitis from repetitive overuse, but in chronic cases recurrent tendinitis can evolve into tendinosis and eventually into tendon tears, commonly involving the gluteus medius tendon. The trochanteric bursa can become inflamed (bursitis) as it attempts to lubricate the injured tendons. The trochanteric bursa (shown in video below) can become inflamed in isolation after direct impact to the outside (lateral) aspect of the hip girdle. All of these injuries can be painful and cause functional problems in different ways. Surprising to many is that fact that when the hip joint causes pain it is usually experienced deep in the groin in the front of the body. Some people refer to their buttock as their hip, but buttock pain is usually referred from the low back or from joints in the back of the pelvis called the sacroiliac joints rather than coming from the hip joints.
Commonly Treated Hip Pain Diagnoses: Hip (femoroacetabular) Joint Arthritis, Femoroacetabular Impingement (FAI), Hip (acetabular) Labrum Tear, Gluteal Muscle Tendinitis, Gluteal Muscle Tendon Tear, Trochanteric Bursitis.
Depending on the magnitude of degenerative change, the extent of tendon or labrum tear and of course the degree to which a person prioritizes avoiding a surgical intervention, Regenerative Medicine treatments can be considered for any of the hip injuries listed above. Call the Regenerative Spine & Joint Center today to find out if you are a candidate for Regenerative Medicine interventions for your hip pain. After discussing your hip history with you, performing a detailed physical examination and reviewing available imaging studies (x-ray, MRI, etc.) Dr. Terebuh will be able to give you his specific recommendations regarding whether or not Bone Marrow Cell Therapy or Platelet Rich Plasma (PRP) Therapy will help you accomplish the goals you have for your hip.