Disorders Which Might Occur With The Hip Joint
The hip is regarded as a ball and socket joint. The ball component is named the femoral head, and is at the end of the thigh bone (femur). The socket is named the acetabulum and this is part of the pelvis. The joint surfaces that move towards each other are coated with a structure called cartilage that is lubricated with fluid; this allows the joint to move with no resistance. Encompassing the hip joint are the capsule, ligaments, muscles, fascia, nerves and blood vessels. There’s a structure referred to as labrum which attaches to the boney rim of the acetabulum which acts to deepen the socket and have a operate as a vacuum seal.
Femoral Acetabular Impingement (FAI)
The shape, size and form of the hip joint can differ from person to person. This may be from how we are genetically hard-wired, or how the hip joint develops as we go from childhood to adulthood, or other reasons such as injury or pathology. Listed below, we have tried to simplify the distinct types of boney differences which often can cause impingement, but it is essential to appreciate that there can be different degrees of these and variations.
1.PINCER – This is when the boney rim of the socket (acetabulum) is covering up more of the ball (femoral head) than in the average hip. A specific area of the socket is afflicted, and this results in ‘pinching’ of the hip joint structures any time the hip joint moves, thus termed impingement. In a number of people, there is global overcoverage (involves the entire socket), and this is termed Coxa Profunda.
2.CAM – This phrase refers to a boney bump that is present towards the top of the thigh bone (femoral neck). This bump can make the ball of the hip joint less spherical, and and once the hip joint moves, this bump can rub or catch against the hip joint structures.
3.CAM/PINCER MIXED IMPINGEMENT – From time to time there might be overcoverage of the socket (pincer/coxa profunda) and in addition to this, the boney bump (CAM) on the femur.
Hip Dysplasia
This is a condition where the socket is not covering the ball (femoral head), sufficiently. There are different levels of this. Measurements called the ‘centre edge angle’ are taken from the xray to establish how much deficiency of coverage there is. Some patients are given a precise operation by consultant Surgeons termed a peri-acetabular osteotomy (PAO) to help correct this.
Hip Labral Tears
The fibrocartilagenous labrum which encompasses the socket can occasionally be torn or become degenerate. There are different classifications of this and it can be caused by various reasons including through injury or hip joint irregularities such as FAI and dysplasia.
If you are affected by any of the injuries described in this article, you should consult your nearest hip arthroscopy physio.
By Louise Grant Physio in North Leeds