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Disorders Which Might Occur With The Hip Joint
The hip can be described as ball and socket joint. The ball component is known as 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 protected with a structure called cartilage which is lubricated with fluid; this allows the joint to move without friction. Encompassing the hip joint are the capsule, ligaments, muscles, fascia, nerves and blood vessels. There’s a structure called the labrum which attaches to the boney rim of the acetabulum which serves to deepen the socket and have a function as a vacuum seal.
Femoral Acetabular Impingement (FAI)
The shape, size and form of the hip joint can fluctuate from individual to individual. This may be from how we are genetically programmed, or how the hip joint evolves as we go from childhood to adulthood, or other causes such as injury or pathology. Listed below, we have tried to simplify the various types of boney differences which often can cause impingement, but it is necessary to appreciate that there can be various 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 typical hip. A specific area of the socket is afflicted, and this causes ‘pinching’ of the hip joint structures any time the hip joint moves, thus termed impingement. In some people, there is global overcoverage (involves the whole socket), and this is named Coxa Profunda.
2.CAM – This phrase refers to a boney lump that is found at the top of the thigh bone (femoral neck). This lump can make the ball of the hip joint less rounded, and so when the hip joint moves, this lump 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 additionally, the boney bump (CAM) on the femur.
Hip Dysplasia
This is a ailment where the socket is not covering the ball (femoral head), sufficiently. There are various levels of this. Measurements named the ‘centre edge angle’ are obtained from the xray to establish how much deficiency of coverage there is. Some sufferers are given a specific operation by specialist Surgeons known as a peri-acetabular osteotomy (PAO) to help remedy this.
Hip Labral Tears
The fibrocartilagenous labrum which surrounds the socket can at times be torn or become degenerate. There are various categories of this and it can be caused by various factors 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 Physiotherapist Leeds