Hip pain in young adults can be difficult to diagnose and treat effectively. In this report, Dr. C. L. Peters (Salt Lake, Utah) reviews new understanding and recent advances in the treatment of this problem.
Better imaging studies with X-rays, CT scans, and MRIs have made it possible to see what’s going on inside the hip. Many times changes in the shape and position of the hip socket or the femoral head inside the socket can be blamed for painful symptoms. Doctors refer to this cause as abnormal morphology (form and structure) of the hip.
Before doing surgery to repair the problem, Dr. Peters points out it’s important to identify both the damage and the cause of the damage. Getting to the root cause is as important as repairing soft tissue tears and uneven wear on the cartilage.
Surgical dislocatio and debridemen is discussed as a treatment option for pinching of the hip called impingement. Once the hip is popped out of the socket (dislocation), the head of the femur can be scraped smooth again (debridement).
The author says this treatment works well for many patients with impingement. In some cases, arthroscopic surgery does not solve the problem. It may be necessary to open the hip in order to restore a more normal alignment.
Continued future improvements in imaging studies will help diagnosis and treatment planning for young patients with hip pain. Using computer 3-D programs, the surgeon will be able to see clearly what is the problem. Damage to the cartilage and joint surface is one important step. But correcting the underlying cause is even more important.