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Femoroacetabular Impingement (FAI)
Femoroacetabular Impingement (FAI) Treatment and Surgery in Wayne & Paramus, NJ
FAI is a congenital abnormality in which there is abnormal bone growth/formation of the bones that make up the hip joint.
Femoracetabular impingement (FAI) is caused by abnormal bone growth/formation of the bones that make up the hip joint — the femoral head (ball) and the acetabulum (socket). FAI occurs because the hip bones form abnormally during childhood. There are three types of FAI: pincer — bone growth over the rim of the acetabulum; cam — abnormally shaped femoral head; and combined impingement — both pincer and cam type impingement are present. Symptoms can take several years or decades to present, but when they do, it often indicates that there is damage to the cartilage or labrum due to the abnormality. Symptoms often present as pain in the groin, stiffness and limping. A thorough examination in the office coupled with imaging can confirm this diagnosis. Conservative treatment is often initiated as first-line therapy, implementing lifestyle modifications, physical therapy and anti-inflammatory medication. If conservative treatment fails or pain progresses to a severity that effects daily living, arthroscopic surgery may be indicated as the first-line surgical intervention utilized. During this procedure, the surgeon can remove frayed or damaged areas to the labrum and articular cartilage and shave down the bony abnormalities. In some cases, an open surgical approach may be necessary to accomplish this in order to establish adequate pain relief.
Hip Fracture Treatment and Surgery in Wayne & Paramus, NJ
Hip fractures are breaks in the upper quarter of the thigh bone (femur).
Hip fractures are breaks in the upper quarter of the thigh bone (femur) and are often seen with high-impact trauma directly to the hip in younger adults or from a fall to the hip in the geriatric population or those with medical conditions that can affect the integrity of the bone (i.e. osteoporosis, cancer). Symptoms often are acute and present as severe pain to the hip and groin area with any movement and an inability to walk. Often the effected limb will appear shortened and rotated as a result. Imaging can confirm this diagnosis, and in some cases advanced imaging may be utilized to evaluate the fracture. There are three types of hip fractures, and it is important for your surgeon to determine exactly which type of fracture is present, as the type of treatment is determined by the type of fracture, location and fracture pattern, and patient’s medical condition. If the patient is medically stable for surgery, surgical intervention is often recommended for an optimal prognosis. Rehabilitation with physical therapy is an important aspect to the recovery process.
Hip Arthritis Treatment and Surgery in Wayne & Paramus, NJ
Hip arthritis is common and often occurs as we advance in age from chronic “wear-and-tear” of the joint where the cartilage damages and wears away over time.
Hip arthritis is common and often occurs as we advance in age from chronic “wear-and-tear” of the joint where the cartilage damages and wears away over time, decreasing the protective joint space between the femoral head (ball) and acetabulum (socket). This type of arthritis is known as osteoarthritis. Often, degenerative changes can be seen on x-ray as joint space narrowing and osteophytes (bone spurs). Arthritis in the hip can also be caused by inflammatory conditions, after trauma to the joint, or due to a congenital abnormality, but these types of arthritis are less common. Pain from arthritis in the hip may be felt directly at the hip, but often pain can be referred to the groin, down the thigh, at the level of the knee and can also be referred posteriorly to the buttocks or lower back. As arthritis progresses, you may experience loss of motion at the hip, crepitus, limping, tenderness and difficulty leaning on the effected side. Nonsurgical treatment is standard as the initial treatment for hip arthritis, often done by implementing lifestyle modifications, physical therapy and cortisone injections. If conservative treatment fails or the arthritis in the hip is severe causing significant pain and limitations of everyday life, you may be a candidate for a total hip arthroplasty (frequently referred to as a total hip replacement).
Hip Strains Treatment and Surgery in Wayne & Paramus, NJ
Injury to the muscles that surround the hip joint.
The hip joint has various muscles surrounding the joint space providing the hip with stability and motion. When one or more of the muscles is stretched beyond its limits, it can become injured or torn causing pain, swelling, weakness and limited motion. Strains can range from mild to severe. Mild muscle strains can often be treated conservatively with rest, heat and anti-inflammatory medication. Moderate and severe muscle strains may require a more specified treatment course with physical therapy or a home exercise program to help strengthen the muscles that support the hip. It is rare that surgical intervention is needed when treating muscle strains. One can expect a recovery period of about 10 to 14 days for mild to moderate strains and longer for more severe strains. The best way to prevent muscle strains is a good stretching protocol used before and after physical activity.
Hip Bursitis Treatment and Surgery in Wayne & Paramus, NJ
Bursitis of the hip which becomes inflamed and irritated.
Bursae are fluid-filled jelly-like sacs that act as cushions between bone and soft tissue for many joints throughout the body, most notably the shoulder, elbow, hip, knee and heel. When this area is irritated, it can become inflamed, causing localized pain, better known as bursitis. Typically, this is caused by repetitive stress or overuse, acute injury to the area, history of surgery to the joint, bone spurs or calcium deposits in the tendons surrounding the bursa causing irritation. Symptoms present as pain worsened with continued repetitive motion, when resting on the affected side and at night.
There are two major bursae in the hip that typically become irritated. The first one can be found over the greater trochanter, also known as trochanteric bursitis, where pain is usually felt at the outside of the thigh area. The second one is located inside of the hip joint close to the groin, commonly referred more generally as hip bursitis, and pain is often felt at the affected sided groin. A clinical exam in the office is often all that is needed for a diagnosis. Initial treatment for hip bursitis is often noninvasive and includes lifestyle modifications, NSAIDs and physical therapy. Sometimes a simple cortisone injection to the bursa is used for immediate, and sometimes permanent, relief. Surgical intervention is rarely ever needed for hip bursitis. Prevention is key when hoping to avoid bursitis. Some modifications one can do to avoid this would be weight loss, avoiding repetitive activities that put stress on the hips, and maintaining strength and flexibility of the hip muscles.
Sciatica Treatment and Surgery in Wayne & Paramus, NJ
Nerve compression at the lumbar spine causing pain, and sometimes numbness, to the
lower back which radiates to the hips, buttocks and down the back of the legs.
Sciatica is a relatively common condition that causes pain and burning along the path of the sciatic nerve — typically from the lower back which radiates to the hips, buttocks and down the back of the legs. This is most commonly due to a protruding (herniated) disk, a bone spur on the vertebrate or narrowing of the lumbar spine (spinal stenosis), all of which can compress the nerve roots that make up the sciatic nerve. Symptoms of sciatica include pain, a burning sensation and sometimes numbness along the sciatic nerve distribution route. The pain can present in varying degrees, from a mild ache to a sharp “knife-like” burning sensation. Usually only one side of the body is affected. Risk factors for developing sciatica include age, obesity, prolonged sitting, occupations that require frequent twisting or carrying heavy loads, and some conditions like diabetes and pregnancy. Sciatica is almost always treated conservatively (See our “Treatments” section for more sciatica treatment information). You should see your doctor if the symptoms persist, if the pain is severe and numbness or weakness present in your leg, or if you have trouble controlling your bowels or bladder.
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