There are a variety of causes of hip pain in individuals. The differential diagnosis is typically based upon age and presentation.
For the older individual, typically we are more concerned about changes within the joint related to arthritis.
For the younger individual who does not have arthritis, the non-arthritic hip pain can be quite varied in terms of how that presents. One of the more common reasons that we see is related to hip impingement. Hip impingement as well as muscle or tendon injury around the hip, or other sources that can be referred to the hip are all part of the differential diagnosis of hip pain.
Hip impingement is an abnormality related to the hip joint. The hip joint is made up of the cup and the ball, the acetabulum being the cup or socket, and the ball being the femur. When you have extra bone on the side of the femur, that can cause hip impingement.
Sometimes when you have over-coverage of the socket, that can also cause hip impingement. A lot of times both are in conjunction. But nonetheless, when these do occur, that can cause pain, typically by the premature block in the range of motion of the hip.
Treatments for hip impingement vary. But typically when someone does present with hip impingement, we typically try conservative measures. Strengthening the muscles of the hip and the core can provide better stability to the hip. Typically, that is an initial first line treatment.
For those that do not respond or still have persistent symptoms and other signs of pathology — a lot of times with a labral tear or other conditions associated with it — then arthroscopy is another way to address it.
Hip arthroscopy is the fastest growing segment of sports medicine. It’s something that has developed in the last 10 to 15 years. We’ve come a long way in between there. We have noticed that people have done exceptionally well from hip arthroscopy, especially in the short mid-term outcomes.
Hip arthroscopy is a minimally invasive procedure. We use keyhole incisions around the hip to address all the pathology that is present within the hip. Patients typically are able to go home the same day.
Recovery starts immediately and we typically get them started in physical therapy within a few days, if not sooner, after surgery. People enjoy this because recovery is typically much quicker and much different than what was offered to them beforehand when it was an inpatient procedure with an open incision and typically a dislocation to address all the same issues that we are now able to do on an outpatient basis.