Other Hip Conditions

Hip Fracture

What is a hip fracture?

If you have fractured your hip, you have broken the top of your thigh bone, most likely between the main part of the bone and the ball part of the hip socket joint. Sometimes the bones don’t separate after breaking, which makes the fracture hard to diagnose. This is called an occult (hidden) hip fracture.

Hip fractures are more common in older people, particularly those with osteoporosis. Some medications, balance problems and poor vision (leading to trips and falls) increase the risk of hip fractures.

A hip fracture is a very serious condition. It can cause you to be immobile for a long period of time, leading to complications such as blood clots, pneumonia, urinary tract infections, bed sore and loss of muscles. Around half of the people who have a hip fracture can’t return to independent living afterwards.

About one in 5 people who fracture their hip will have another hip fracture within 2 years.

What are the symptoms of hip fracture?

The symptoms of hip fracture are:

  • severe pain in your groin or front of your hip
  • being unable to bear weight on the affected leg
  • swelling, stiffness and bruising of your hip
  • the affected leg appearing shorter than the other one
  • being unable to get up after falling

What does your doctor look for?

Your doctor will take your medical history, including asking about how you hurt your hip, what other conditions you have, what medications you take and any previous fractures. Your doctor will also perform a physical examination that will include an assessment of whether you can bear weight on your leg and how your hip moves.

What investigations are needed?

Your doctor will often be able to tell that you have a hip fracture from your symptoms and physical examination. You will probably have an X-ray to confirm the fracture and show where the fracture is located.

Sometimes the fracture doesn’t show up on X-ray (eg occult fractures can be hard to see). In this case, you might need an MRI or bone scan to see the fracture.

How is a hip fracture treated?

Hip fractures are generally treated with surgery, in combination with medication and rehabilitation.

Hip fracture surgery

The type of surgery needed depends on the location and severity of the fracture, and on your general health and age. Options include:

  • repairing the fracture with metal screws to hold the broken parts together
  • partial hip replacement, where your surgeon removes the top of the thigh bone including the ball part of the hip socket joint and replaces this with a metal implant (prosthesis)
  • total hip replacement, where both the ball and the socket part of the hip joint are removed and replaced with prostheses

Rehabilitation starts soon after surgery (usually the next day) to help get you moving and shorten the length of time you are immobile.

Apart from pain medication, to reduce the risk of another hip fracture, medications called bisphosphates may also be prescribed.

Our specialists at Orthopaedic Clinics Gold Coast will work with you to create the best treatment plan for your particular situation.

Avascular necrosis

What is avascular necrosis?

Avascular necrosis is a condition where the ball part of the hip socket joint (the femoral head) loses its blood supply. Without a good blood supply to bring in nutrients, the bone and marrow cells die and eventually the femoral head collapses. This leads to arthritis.

Avascular necrosis tends to affect young and middle-aged people. We don’t always know why it occurs, but it is linked to previous injury (eg hip dislocation), taking steroid medication and drinking too much alcohol.

What are the symptoms of avascular necrosis?

In the early stages of the condition, there may not be any symptoms. As it progresses, you may feel pain:

  • when you stand on the affected leg (as the condition worsens, pain may occur all of the time)
  • in the groin, thigh or buttock of the affected leg, but also pain in other places that avascular necrosis can occur (eg knee, hand, foot and shoulder)

Avascular necrosis may affect the hip joints on both sides.

What does your doctor look for?

Your doctor will take your medical history (including medication use and alcohol intake) and ask you questions about your pain such as when it started, where it hurts most and if there are any positions that make it feel better or worse.

Your doctor will also examine your hip, checking for tenderness and how much your hip can move.

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What investigations are needed?

There are many different disorders that cause hip pain and imaging can be useful in making a diagnosis. Your doctor may request:

  • X-rays, which can show changes in the later stages of avascular necrosis but are usually normal in the beginning
  • a CT or MRI scan, which can show early changes
  • a bone scan

How is avascular necrosis treated?

Treatment for avascular necrosis will depend on the amount of bone damage that has occurred. In the early stages of the condition, treatment options include:

  • non-drug therapy (eg physiotherapy, rest and electrical stimulation)
  • medications (eg anti-inflammatories, osteoporosis drugs, blood thinners)

For more advanced cases, treatments are:

  • bone transplant or bone reshaping, which are usually done via arthroscopy
  • hip joint replacement

Our specialists at Orthopaedic Clinics Gold Coast will work with you to create the best treatment plan for your particular situation.

Trochanteric bursitis

What is trochanteric bursitis?

A bursa is a fluid-filled sac within a joint that provides cushioning and support. Each hip has two major bursae: the trochanteric bursa (on the outside point of the hip) and the iliopsoas bursa (on the inside of the hip). When a bursa becomes inflamed, this is called bursitis. So trochanteric bursitis is inflammation of the trochanteric bursa. This condition is also called greater trochanteric pain syndrome.

The trochanteric bursa may become inflamed from overuse or injury of your hip. It is also caused by posture, gout, muscle tears and it can be a complication of hip surgery.

It’s a common problem in middle aged and older people, although any age group can be affected.

What are the symptoms?

Hip pain is the main symptom of trochanteric bursitis. The pain may start on the outside of your hip and be quite sharp. It will usually turn into a dull ache and start to improve over about 2 weeks.

Your hip may be tender to touch and in some rare cases will be red and swollen.

What does your doctor look for?

Your doctor will ask you about your medical history and ask about how long you’ve had your pain and what movements make it feel better or worse. Your doctor will also perform a physical examination which will include assessing how you hip moves and functions.

What investigations are needed?

The bursa doesn’t show up on X-ray but your doctor may request one to rule out other causes of hip pain. You may also be asked to have an ultrasound or MRI, although usually only if your pain isn’t improving with treatment.

How is trochanteric bursitis treated?

Trochanteric bursitis is usually treated with:

  • non-drug therapy (eg ice, rest and physiotherapy, shock-wave therapy)
  • injections
  • medications (eg anti-inflammatories)

Surgery is rarely needed, but if the bursa is damaged beyond repair, it can be removed. This is usually done via arthroscopy (keyhole surgery).

Our specialists at Orthopaedic Clinics Gold Coast will work with you to create the best treatment plan for your particular situation.