What could be causing pain in the lower right abdomen near the hip bone? Discover 19 possible causes, from indigestion to appendicitis, and learn about their symptoms, diagnosis, and treatment options.

Understanding Pain in the Lower Right Abdomen Near the Hip Bone

Pain in the lower right abdomen near the hip bone can have a variety of causes, ranging from minor digestive issues to more serious medical conditions. It’s important to understand the potential causes and their associated symptoms to determine when to seek medical attention. In this comprehensive article, we will explore 19 potential causes of this type of abdominal pain, providing an overview of each condition, its symptoms, diagnosis, and treatment options.

Less Serious Causes of Lower Right Abdominal Pain

Many of the less serious causes of lower right abdominal pain are temporary and may resolve without any specific treatment. However, if the pain persists or worsens, it’s important to consult a healthcare professional.

Indigestion

Indigestion is the abdominal pain and feelings of fullness and nausea that result from difficulty digesting something. Possible causes include eating too much or too quickly, consuming fatty or spicy foods, or experiencing anxiety. Symptoms may also include nausea, vomiting, and heartburn.

Gas

Gas in the intestines is usually caused by bacteria in the digestive tract or by swallowing too much air. This can lead to lower abdominal pain as the gas moves through the intestine, as well as feelings of bloating or fullness and the passing of gas.

Constipation

Constipation is the infrequent or difficult passage of stool. In addition to abdominal pain, symptoms may include straining during bowel movements, hard or lumpy stools, and having three or fewer bowel movements per week.

Muscle Pull and Strain

A strained or pulled abdominal muscle can cause sharp pain, swelling, bruising, and difficulty flexing the muscle or standing up straight. This is typically the result of a sports injury or accident.

Muscle Spasm

A muscle spasm is an unintentional, uncomfortable contraction of a muscle. Abdominal muscle spasms can be caused by dehydration, electrolyte imbalances, or straining the muscles during exercise.

Gastroenteritis

Inflammation of the gastrointestinal tract, often caused by a bacterial, viral, or parasitic infection, can lead to abdominal pain, diarrhea, vomiting, fever, and other symptoms.

Gastritis

Gastritis is an inflammation of the stomach lining, which can be caused by a bacterial infection or weaknesses in the stomach lining. In addition to lower abdominal pain, symptoms may include nausea and vomiting.

Serious Causes of Lower Right Abdominal Pain

Some of the more serious causes of pain in the lower right abdomen near the hip bone may require surgery or long-term medical treatment. Prompt diagnosis and treatment are crucial for these conditions.

Appendicitis

Appendicitis is the inflammation and potential rupture of the appendix, a small pouch extending from the large intestine. Symptoms include nausea, vomiting, fever, and abdominal swelling, in addition to the lower right abdominal pain. Appendicitis is a medical emergency that requires immediate treatment.

Kidney Stones

Kidney stones are small crystals that form in the kidneys and can cause intense pain in the side of the abdomen, as well as blood in the urine, painful urination, nausea, chills, and fever.

Kidney Infection

A kidney infection, often starting as a urinary tract infection, can cause abdominal pain in addition to other symptoms such as fever, chills, and nausea.

Female-Specific Causes of Lower Right Abdominal Pain

Certain conditions that can cause lower right abdominal pain are specific to women.

Menstrual Pain

Cramps and discomfort during menstruation can lead to pain in the lower right abdomen, as well as other areas of the abdomen.

Ovarian Cyst

Ovarian cysts, fluid-filled sacs that develop on the ovaries, can cause lower abdominal pain, especially if they rupture or become twisted.

Pelvic Inflammatory Disease (PID)

PID is an infection of the female reproductive organs that can lead to lower abdominal pain, as well as fever, abnormal vaginal discharge, and pain during intercourse.

Endometriosis

Endometriosis is a condition in which the uterine lining grows outside the uterus, causing chronic pelvic pain and lower abdominal discomfort.

Ectopic Pregnancy

An ectopic pregnancy, in which the fertilized egg implants outside the uterus, can cause severe lower abdominal pain and is a medical emergency.

Male-Specific Causes of Lower Right Abdominal Pain

While many of the causes of lower right abdominal pain can affect both men and women, there are a few conditions that are more specific to men.

Testicular Torsion

Testicular torsion is a medical emergency in which the testicle twists, cutting off blood supply. This can cause severe lower abdominal and groin pain, as well as nausea and vomiting.

If you are experiencing persistent or severe pain in the lower right abdomen near the hip bone, it’s important to consult a healthcare professional to determine the underlying cause and receive the appropriate treatment. By understanding the potential causes and their associated symptoms, you can be better prepared to advocate for your health and seek the necessary medical attention.

Pain in Lower Right Abdomen Near the Hip Bone: 19 Causes

Pain in your side by the hip bone can occur with gas, indigestion, or other temporary ailments. But if the pain is severe or occurs with other symptoms, it may be an early indicator of a more serious health issue.

Pain in the lower right abdomen near the hip bone can be caused by many conditions, ranging from indigestion after a spicy meal to emergencies — such as appendicitis — that require surgery to treat.

In many cases, the presence of other symptoms can help identify the source of your abdominal pain and whether you’ll need to consult with a doctor.

We’ll take a look at 19 potential causes of pain in the lower right abdomen, as well as their symptoms, how they’re diagnosed, and your treatment options.

Many of the less serious causes of lower right abdominal pain are temporary and will pass without any treatment. Others may persist and require rest or medications for relief.

1. Indigestion

Indigestion is the abdominal pain and feelings of fullness and nausea that result when you’re having trouble digesting something. Possible causes include:

• eating too much or too quickly
• eating fatty or spicy foods
• consuming too much caffeine, alcohol, chocolate, or carbonated beverages
• experiencing anxiety
• taking certain medications, such as antibiotics and pain relievers

Other symptoms you may experience with indigestion may include:

• nausea and vomiting
• feeling full early in a meal
• heartburn

2. Gas

Gas in your intestine is usually brought on by bacteria in your digestive tract or by swallowing too much air. You may feel lower abdominal pain as gas moves through your intestine. Other symptoms may include:

• feeling bloated or unusually full in the abdomen
• passing gas
• burping

3.

Constipation

Being constipated means having infrequent bowel movements or having difficulty passing stools.

In addition to feeling pain in the abdomen and feeling as though something is blocking bowel movements in the rectum, constipation symptoms include:

• straining during a bowel movement
• hard or lumpy stools
• having three or fewer bowel movements per week

4. Muscle pull and strain

A strained or pulled muscle refers to any tear, excessive stretch, or rupture of a muscle, typically from a sports or work injury or an accident.

When it’s an abdominal muscle, it can feel like a sharp pain, coupled with swelling, bruising, and stiffness. You may also have difficulty flexing the muscle or even standing up straight and walking.

5. Muscle spasm

A muscle spasm is an uncomfortable, unintentional muscle contraction. It can feel like an annoying little twitch or, if it lasts for more than a couple of seconds, a muscle spasm can hurt quite a bit.

Straining your abdominal muscles during a workout can cause a spasm. Your muscles may be more vulnerable to a spasm if you’re dehydrated.

You’re also more vulnerable if you have low levels of electrolytes, such as magnesium, calcium, and potassium.

6. Gastroenteritis

Inflammation of the gastrointestinal tract may be caused by a bacterial, viral, or parasitic infection. Along with lower abdominal pain or cramping, some other symptoms include:

• diarrhea
• vomiting
• fever
• abnormal sweating
• muscle pain and joint stiffness

7. Gastritis

Weakness in your stomach lining or a certain type of bacterial infection (Helicobacter pylori) can cause gastritis, an inflammation of the stomach lining.

You may feel pain in the upper and lower abdomen. You may also experience nausea and vomiting.

Some of the more serious causes of pain in the lower right abdomen near the hip bone may require surgery or long-term medical treatment.

8. Appendicitis

Your appendix is a small finger-like pouch extending down from the large intestine. When it becomes infected and inflamed, the result is appendicitis. If untreated, the appendix can burst, infecting the abdominal cavity.

Appendicitis is a leading cause of pain in the lower right abdomen, but it usually has other symptoms. These symptoms are:

• nausea
• vomiting
• fever
• abdominal swelling

Seek immediate medical attention if you have pain in the lower right abdomen along with the above symptoms.

9. Kidney stones

When small crystals of calcium, uric acid or other chemicals form in your kidneys, they’re called kidney stones. They can cause intense pain in the side of the abdomen, as well as:

• blood in the urine
• painful urination
• nausea
• chills
• fever

10. Kidney infection

A kidney infection often starts as a urinary tract infection. In addition to abdominal pain, a kidney infection can also cause:

• back pain
• frequent urination
• burning sensation when urinating
• foul-smelling urine
• fever
• chills
• nausea

11.

Inflammatory bowel disease (IBD)

IBD is actually a group of intestinal diseases that include ulcerative colitis and Crohn’s disease. Symptoms vary, depending on the type of IBD. They can include abdominal pain, diarrhea, and bloating.

12. Irritable bowel syndrome (IBS)

Unlike IBD, IBS doesn’t cause inflammation or injure the bowel. It’s also not clear what causes IBS.

Stress and certain types of foods, such as dairy, wheat, and citrus can trigger symptoms. Common symptoms include lower abdominal pain, diarrhea, excess gas, and mucus in the stool.

13. Hernia

A hernia occurs when an organ or other body part pushes through the wall of muscle or tissue that normally contains it.

There are several different types of hernias. A hernia can be painful and get worse when lifting something. It can also cause swelling.

An inguinal hernia occurs when tissue pushes through the abdominal wall and into the inguinal canal. The canal surrounds the spermatic cords in males and the uterus ligament in females.

While both sexes can develop inguinal hernias, men are far more likely to experience this painful condition.

Symptoms include a sharp pain on one side of the groin and pain that’s triggered by coughing, exercising, or bending over.

If you’re female, here are some potential causes of pain in the lower right abdomen.

14. Menstrual pain

Menstrual cramps in the lower abdomen can occur before or during your period. The pain may even radiate down into your legs. Some pain and cramping during menstrual periods is normal.

Excessive pain — called dysmenorrhea — is not. Talk with a doctor if your menstrual pain is causing you to miss work, school, or other daily activities.

15. Ovarian cyst

An ovarian cyst is a small fluid-filled sac that forms on your ovary. It can cause a lot of pain in the lower abdomen as well as:

• back pain
• pelvic pain during or before your menstrual cycle
• painful intercourse
• nausea and vomiting
• painful bowel movements

16.

Pelvic inflammatory disease (PID)

Pelvic inflammatory disease (PID) is an inflammation of the reproductive organs, often caused by a sexually transmitted infection (STI) or other infection. In addition to abdominal pain, you may experience:

• pain during intercourse
• burning sensation when urinating
• unusual discharge and odor from your vagina
• fever

17. Endometriosis

Endometriosis occurs when tissue — like the kind that lines the inside of the uterus — starts to grow elsewhere, such as the ovaries, bowel, or around the pelvis.

Depending on where the endometrial tissue is growing, symptoms can include:

• pain in the pelvic region
• painful periods
• painful bowel movements
• cramps during or around menstruation
• pain after intercourse

18. Ectopic pregnancy

When a fertilized egg doesn’t attach itself to the uterus, but instead settles into a fallopian tube or elsewhere in the abdominal cavity, it’s called an ectopic pregnancy.

Along with sharp pain in the side of the abdomen and pelvis, you may experience:

• shoulder or neck pain
• dizziness or fainting
• light to heavy vaginal bleeding

If you’re male, there are some additional potential causes of pain in the lower right abdomen.

19. Testicular torsion

When the spermatic cord, which carries blood to the scrotum, becomes twisted, it’s called testicular torsion.

Pain is usually felt in the scrotum and the side of the lower abdomen. There may also be swelling in the scrotum, as well as nausea and fever.

To diagnose the cause of your lower right abdominal pain, your doctor will review your symptoms and medical history, and do a physical exam.

The exam may include applying gentle pressure to your abdomen to check for swelling or tenderness. Other diagnostic tests may include:

Ultrasound

An ultrasound uses sound waves to create images inside the body. It can be used to help detect tumors, examine the ovaries and uterus during pregnancy, examine a man’s prostate, and look for other concerns.

CT scans

Computed tomography (CT) scans are made up of layers of X-rays taken at different angles to provide a more detailed view than a standard X-ray.

MRI scans

Magnetic resonance imaging (MRI) uses a magnetic field and radio waves to produce detailed views of organs and other soft tissue.

Endoscopy

An endoscope is a long, thin, flexible tube that can be inserted down the throat and through the esophagus and as far as the small intestine to look for bacterial infections and other signs of trouble.

Blood tests

A blood test can reveal a lot about a person’s health, such as the elevation of white blood cells, which can indicate an infection.

You can always start talking with your doctor if you’re experiencing pain in your lower right abdomen. You may want talk with your doctor about a referral to a specialist based on your healthcare needs.

Specialists include:

• Gastroenterologist. These doctors specialize in the health of the digestive system.
• Urologist. These doctors specialize in the health of the urinary tract and the male reproductive system.
• Obstetrician-gynecologist. These doctors specialize in women’s health.

The right treatment for your lower right abdomen depends on the cause of the problem. Treatment approaches include:

Time

Conditions that usually just need time to heal include:

• indigestion
• gas
• viral gastroenteritis and other viral infections
• pulled muscle
• menstrual cramps

Change in diet

Indigestion and gas problems may be avoided by skipping certain food triggers. IBD and IBS, however, are chronic conditions that require continuous monitoring and careful food choices.

Antibiotics

Bacterial infections, such as appendicitis and PID, usually require antibiotics.

Surgery and other procedures

Causes that usually require surgery to remove the cause of the pain include:

• appendicitis
• ovarian cyst
• testicular torsion
• kidney stones, which are often treated with procedures such as laser or shock wave therapy to break up the stones

Pain in the lower right abdomen can sometimes indicate a medical emergency, such as appendicitis.

However, it’s usually a much less serious problem that’s temporary and may not require any medical intervention.

The key is to pay attention to all of your symptoms. Note when they started and think about whether you’ve had similar pains before.

If you think spicy food is to blame, a simple dietary change may be all that’s needed to avoid this problem in the future.

Pain in Lower Right Abdomen Near the Hip Bone: 19 Causes

Pain in your side by the hip bone can occur with gas, indigestion, or other temporary ailments. But if the pain is severe or occurs with other symptoms, it may be an early indicator of a more serious health issue.

Pain in the lower right abdomen near the hip bone can be caused by many conditions, ranging from indigestion after a spicy meal to emergencies — such as appendicitis — that require surgery to treat.

In many cases, the presence of other symptoms can help identify the source of your abdominal pain and whether you’ll need to consult with a doctor.

We’ll take a look at 19 potential causes of pain in the lower right abdomen, as well as their symptoms, how they’re diagnosed, and your treatment options.

Many of the less serious causes of lower right abdominal pain are temporary and will pass without any treatment. Others may persist and require rest or medications for relief.

1. Indigestion

Indigestion is the abdominal pain and feelings of fullness and nausea that result when you’re having trouble digesting something. Possible causes include:

• eating too much or too quickly
• eating fatty or spicy foods
• consuming too much caffeine, alcohol, chocolate, or carbonated beverages
• experiencing anxiety
• taking certain medications, such as antibiotics and pain relievers

Other symptoms you may experience with indigestion may include:

• nausea and vomiting
• feeling full early in a meal
• heartburn

2. Gas

Gas in your intestine is usually brought on by bacteria in your digestive tract or by swallowing too much air. You may feel lower abdominal pain as gas moves through your intestine. Other symptoms may include:

• feeling bloated or unusually full in the abdomen
• passing gas
• burping

3.

Constipation

Being constipated means having infrequent bowel movements or having difficulty passing stools.

In addition to feeling pain in the abdomen and feeling as though something is blocking bowel movements in the rectum, constipation symptoms include:

• straining during a bowel movement
• hard or lumpy stools
• having three or fewer bowel movements per week

4. Muscle pull and strain

A strained or pulled muscle refers to any tear, excessive stretch, or rupture of a muscle, typically from a sports or work injury or an accident.

When it’s an abdominal muscle, it can feel like a sharp pain, coupled with swelling, bruising, and stiffness. You may also have difficulty flexing the muscle or even standing up straight and walking.

5. Muscle spasm

A muscle spasm is an uncomfortable, unintentional muscle contraction. It can feel like an annoying little twitch or, if it lasts for more than a couple of seconds, a muscle spasm can hurt quite a bit.

Straining your abdominal muscles during a workout can cause a spasm. Your muscles may be more vulnerable to a spasm if you’re dehydrated.

You’re also more vulnerable if you have low levels of electrolytes, such as magnesium, calcium, and potassium.

6. Gastroenteritis

Inflammation of the gastrointestinal tract may be caused by a bacterial, viral, or parasitic infection. Along with lower abdominal pain or cramping, some other symptoms include:

• diarrhea
• vomiting
• fever
• abnormal sweating
• muscle pain and joint stiffness

7. Gastritis

Weakness in your stomach lining or a certain type of bacterial infection (Helicobacter pylori) can cause gastritis, an inflammation of the stomach lining.

You may feel pain in the upper and lower abdomen. You may also experience nausea and vomiting.

Some of the more serious causes of pain in the lower right abdomen near the hip bone may require surgery or long-term medical treatment.

8. Appendicitis

Your appendix is a small finger-like pouch extending down from the large intestine. When it becomes infected and inflamed, the result is appendicitis. If untreated, the appendix can burst, infecting the abdominal cavity.

Appendicitis is a leading cause of pain in the lower right abdomen, but it usually has other symptoms. These symptoms are:

• nausea
• vomiting
• fever
• abdominal swelling

Seek immediate medical attention if you have pain in the lower right abdomen along with the above symptoms.

9. Kidney stones

When small crystals of calcium, uric acid or other chemicals form in your kidneys, they’re called kidney stones. They can cause intense pain in the side of the abdomen, as well as:

• blood in the urine
• painful urination
• nausea
• chills
• fever

10. Kidney infection

A kidney infection often starts as a urinary tract infection. In addition to abdominal pain, a kidney infection can also cause:

• back pain
• frequent urination
• burning sensation when urinating
• foul-smelling urine
• fever
• chills
• nausea

11.

Inflammatory bowel disease (IBD)

IBD is actually a group of intestinal diseases that include ulcerative colitis and Crohn’s disease. Symptoms vary, depending on the type of IBD. They can include abdominal pain, diarrhea, and bloating.

12. Irritable bowel syndrome (IBS)

Unlike IBD, IBS doesn’t cause inflammation or injure the bowel. It’s also not clear what causes IBS.

Stress and certain types of foods, such as dairy, wheat, and citrus can trigger symptoms. Common symptoms include lower abdominal pain, diarrhea, excess gas, and mucus in the stool.

13. Hernia

A hernia occurs when an organ or other body part pushes through the wall of muscle or tissue that normally contains it.

There are several different types of hernias. A hernia can be painful and get worse when lifting something. It can also cause swelling.

An inguinal hernia occurs when tissue pushes through the abdominal wall and into the inguinal canal. The canal surrounds the spermatic cords in males and the uterus ligament in females.

While both sexes can develop inguinal hernias, men are far more likely to experience this painful condition.

Symptoms include a sharp pain on one side of the groin and pain that’s triggered by coughing, exercising, or bending over.

If you’re female, here are some potential causes of pain in the lower right abdomen.

14. Menstrual pain

Menstrual cramps in the lower abdomen can occur before or during your period. The pain may even radiate down into your legs. Some pain and cramping during menstrual periods is normal.

Excessive pain — called dysmenorrhea — is not. Talk with a doctor if your menstrual pain is causing you to miss work, school, or other daily activities.

15. Ovarian cyst

An ovarian cyst is a small fluid-filled sac that forms on your ovary. It can cause a lot of pain in the lower abdomen as well as:

• back pain
• pelvic pain during or before your menstrual cycle
• painful intercourse
• nausea and vomiting
• painful bowel movements

16.

Pelvic inflammatory disease (PID)

Pelvic inflammatory disease (PID) is an inflammation of the reproductive organs, often caused by a sexually transmitted infection (STI) or other infection. In addition to abdominal pain, you may experience:

• pain during intercourse
• burning sensation when urinating
• unusual discharge and odor from your vagina
• fever

17. Endometriosis

Endometriosis occurs when tissue — like the kind that lines the inside of the uterus — starts to grow elsewhere, such as the ovaries, bowel, or around the pelvis.

Depending on where the endometrial tissue is growing, symptoms can include:

• pain in the pelvic region
• painful periods
• painful bowel movements
• cramps during or around menstruation
• pain after intercourse

18. Ectopic pregnancy

When a fertilized egg doesn’t attach itself to the uterus, but instead settles into a fallopian tube or elsewhere in the abdominal cavity, it’s called an ectopic pregnancy.

Along with sharp pain in the side of the abdomen and pelvis, you may experience:

• shoulder or neck pain
• dizziness or fainting
• light to heavy vaginal bleeding

If you’re male, there are some additional potential causes of pain in the lower right abdomen.

19. Testicular torsion

When the spermatic cord, which carries blood to the scrotum, becomes twisted, it’s called testicular torsion.

Pain is usually felt in the scrotum and the side of the lower abdomen. There may also be swelling in the scrotum, as well as nausea and fever.

To diagnose the cause of your lower right abdominal pain, your doctor will review your symptoms and medical history, and do a physical exam.

The exam may include applying gentle pressure to your abdomen to check for swelling or tenderness. Other diagnostic tests may include:

Ultrasound

An ultrasound uses sound waves to create images inside the body. It can be used to help detect tumors, examine the ovaries and uterus during pregnancy, examine a man’s prostate, and look for other concerns.

CT scans

Computed tomography (CT) scans are made up of layers of X-rays taken at different angles to provide a more detailed view than a standard X-ray.

MRI scans

Magnetic resonance imaging (MRI) uses a magnetic field and radio waves to produce detailed views of organs and other soft tissue.

Endoscopy

An endoscope is a long, thin, flexible tube that can be inserted down the throat and through the esophagus and as far as the small intestine to look for bacterial infections and other signs of trouble.

Blood tests

A blood test can reveal a lot about a person’s health, such as the elevation of white blood cells, which can indicate an infection.

You can always start talking with your doctor if you’re experiencing pain in your lower right abdomen. You may want talk with your doctor about a referral to a specialist based on your healthcare needs.

Specialists include:

• Gastroenterologist. These doctors specialize in the health of the digestive system.
• Urologist. These doctors specialize in the health of the urinary tract and the male reproductive system.
• Obstetrician-gynecologist. These doctors specialize in women’s health.

The right treatment for your lower right abdomen depends on the cause of the problem. Treatment approaches include:

Time

Conditions that usually just need time to heal include:

• indigestion
• gas
• viral gastroenteritis and other viral infections
• pulled muscle
• menstrual cramps

Change in diet

Indigestion and gas problems may be avoided by skipping certain food triggers. IBD and IBS, however, are chronic conditions that require continuous monitoring and careful food choices.

Antibiotics

Bacterial infections, such as appendicitis and PID, usually require antibiotics.

Surgery and other procedures

Causes that usually require surgery to remove the cause of the pain include:

• appendicitis
• ovarian cyst
• testicular torsion
• kidney stones, which are often treated with procedures such as laser or shock wave therapy to break up the stones

Pain in the lower right abdomen can sometimes indicate a medical emergency, such as appendicitis.

However, it’s usually a much less serious problem that’s temporary and may not require any medical intervention.

The key is to pay attention to all of your symptoms. Note when they started and think about whether you’ve had similar pains before.

If you think spicy food is to blame, a simple dietary change may be all that’s needed to avoid this problem in the future.

Hip arthroplasty | City Clinical Hospital. F.I. Inozemtseva

GBUZ GKB im. F.I. Inozemtseva DZM” free of charge, under the policy of compulsory
medical insurance (CHI) perform complex surgical treatment – HIP REPLACEMENT

Hip pain is most often the result of osteoarthritis and can seriously affect your ability to lead a full and active lifestyle. Osteoarthritis of the hip joint in medicine is called coxarthrosis.

Hip arthroplasty will help you get rid of pain and return to a full life. Over the past 20 years, thanks to the introduction of new materials and techniques into practice, the results of arthroplasty operations have significantly improved.

Hip arthroplasty
joint is becoming more and more common as the world’s population
getting old. Currently, hip replacement surgery is
most frequently performed in the world.

Hip arthroplasty
joint is a total or selective replacement of parts of the joint, directly
in contact with each other during movement.

Total hip arthroplasty
joint is a complete replacement of the head and neck of the femur and acetabulum with
artificial.

ANATOMY OF THE HIP JOINT

The hip joint is spherical in structure, so movements in it are possible in many planes. The joint is formed by the acetabulum, forming, as it were, a deep bowl and the head of the femur, which has the shape of a ball.

The femoral head is connected to the main part of the femur (diaphysis) by a short section of bone called the femoral neck. Strong and thick muscles and tendons surround the joint.

Surfaces
the acetabulum and the head of the femur are covered with articular cartilage. Articular cartilage thickness near the floor
centimeters in large joints. Articular cartilage is a hard and smooth material,
covering the bones in the joint area. Articular cartilage allows covered with it
bones to slide smoothly over each other without being damaged. by color
articular cartilage is white and shiny.

The joint is surrounded by a dense waterproof capsule, inside which a special fluid is produced that lubricates the articulating surfaces. The bones in the joint hold tight ligaments and muscles together. The design of the hip joint allows for extremely high mobility while maintaining satisfactory stability.

Powerful muscles all around
joints allow us to move in an upright position for a long time,
and also, if necessary, to make accelerations when running and jumping. Also around
Important nerves and blood vessels pass through the joint.

WHEN DOES IT NEED TO BE REPLACED?

The main indications for hip arthroplasty are arthrosis of the hip joint (coxarthrosis), fracture of the femoral neck, aseptic necrosis of the femoral head.

Arthrosis
degenerative changes occur in the articular cartilage, which ultimately
leads to cartilage wear. Bone growths around the joint
(osteophytes).

Due to wear
cartilage, a decrease in its thickness, a significant decrease in smoothness, as well as
change in the shape of the articular surfaces, friction in the joint increases, which
leads to pain and progressive impairment of movement in the joint.

Aseptic necrosis of the femoral head is another cause of hip joint destruction. In this disease, the head of the femur loses its blood supply and actually collapses. The shape of the femoral head changes, the bone tissue that makes up the head is resorbed.

Articular surfaces of the acetabulum and head
the femur no longer correspond to each other in shape, pain appears
and impaired joint movement. Causes of the disease may be
past hip dislocations, trauma at birth, long-term treatment
corticosteroids, and some infections.

Primary purpose of joint replacement for any of
degenerative diseases to artificial is a reduction in pain and
return of movement. To do this, damaged surfaces are replaced
artificial, resulting in the return of smoothness and painlessness
movements in the joint.

Fracture of the femoral neck is also an indication for joint replacement surgery.

In case of fractures of the neck of the femur, the blood supply to the head is disturbed, in connection with which its gradual destruction occurs.

Fracture union under these conditions is impossible,
surgery is the only way to reactivate the patient and bring him back to
daily activity.

PREPARATION FOR HIP REPLACEMENT

The decision to operate is made by the doctor together with the patient. After clarifying the history of the disease, the doctor performs a thorough clinical examination to measure the current range of motion, the level of pain, the patient’s functionality. During the examination of the patient, the surgeon examines radiographs, as well as data from CT and MRI studies.

You will also need a thorough and complete medical
examination before surgery. This is done so that during the operation
minimize the risk of complications. If long-term
surgery or the patient’s hemoglobin level is below normal, after or
a blood transfusion may be required during surgery. Necessarily
prevention of thromboembolic complications is prescribed.

TYPES OF ENDOPROSTHESES

There are several main types of endoprostheses – cementless and
cement.

Cemented endoprostheses are held in the bone with a special cement that fixes the metal to the bone. The surface of cementless prostheses is made in such a way that the bone tissue grows into it over time, due to which the prosthesis is held in the bone. In order for the endoprosthesis to grow, the bone is processed with special tools.

Both types of endoprosthesis fixation are widely used in medical practice. Also, in some cases, a combination can be used, when, for example, the acetabular component (cup) is fixed with cement, and the femoral component (pedicle) is cementless. The decision to use a cemented or uncemented endoprosthesis is made by the surgeon based on the patient’s age, lifestyle, and bone quality.

The endoprosthesis consists of two main parts.

The acetabular component (cup) replaces the articular surface of the acetabulum. The shell of the acetabular component is made of metal, inside of which is placed a plastic or ceramic insert that is in direct contact with the femoral component.

Femoral component replaces the head and neck of the femur, usually made entirely of metal. In some endoprosthesis designs, the head can be made of ceramic.

Endoprosthetics can
be total when both components are replaced, and unipolar. At
unipolar arthroplasty (hemiarthroplasty), only the femoral
component. Hemiarthroplasty is usually performed for femoral neck fractures.
bones in elderly and debilitated patients.

With this type of arthroplasty, the earliest verticalization of the patient is allowed, the very next day. This significantly reduces the risk of thromboembolic and hypostatic complications in elderly debilitated patients with femoral neck fractures. Also important is the shorter operation time in hemiarthroplasty compared to total arthroplasty, which also reduces the risks during anesthesia and blood loss during surgery. Currently, our clinic uses modern cemented bipolar endoprostheses of the hip joint. A bipolar endoprosthesis is a modern version of a unipolar prosthesis, in which the head is double.

This design of the endoprosthesis increases the service life of the prosthesis, increases its
stability and range of motion.

MORE ABOUT HIP REPLACEMENT

The surgeon accesses the hip joint, the skin incision is made in the upper third of the thigh. Once the hip joint is exposed, surgeons dislocate the worn head of the femur from the acetabulum.

Then the damaged head is resected and
neck of the femur with a special electric saw.

Next, the acetabulum is processed using special cutters. During the treatment, worn cartilage is completely removed and a hemisphere is formed into which the acetabular component will be implanted.

After the acetabular socket has been formed, the surgeon fills the socket with bone cement and places an appropriately sized acetabular component. At this stage, the correct spatial orientation of the acetabular component at the correct angle is important. This affects the service life of the endoprosthesis and the likelihood of complications in the postoperative period.

After setting the cement and fixing the acetabular component, the surgeon proceeds to the femur. At this stage, the bone canal of the femoral canal is developed with special rasps to the required size.

Cement is placed in the prepared femoral canal and the femoral component is placed.

The head of the required size is selected and the femoral component is inserted into the acetabular.

The surgeon then checks the hip stability and range of motion.

Once the surgeon is satisfied that everything is set properly, the wound is sutured in layers. Drains are installed for a day. The patient is sent to a special room in the post-operative department.

The patient’s rehabilitation begins from the first day.

HOW WILL THE POSTOPERATIVE (REHABILITATION) PERIOD GO?

The terms of rehabilitation depend primarily on the type
fixation of the endoprosthesis components. When cemented, full load
possible almost immediately after surgery.

If cementless fixation was used
it is recommended to limit the load on the operated limb for 8-12
weeks after the operation, you need to walk at this time with the help of crutches, with
the purpose of bone tissue ingrowth into the surface of the endoprosthesis components, then
you can go to full load.

Main risk after total arthroplasty
is a dislocation of the head of the femoral component of the endoprosthesis. That’s why
combination of hip flexion and abduction is contraindicated for 6 months after
surgery (the period of recovery of the hip joint capsule dissected during
surgical treatment), sit on low sofas and couches, avoid deep
slopes through the thigh to the floor. Avoid crossing the operated
lower limb with a healthy, being in the position of the foot to the foot. Driving
car possible after 6 weeks from the date of operation.

Recovery is possible after 6
weeks (if the work is not associated with increased physical activity and
prolonged standing), 12 weeks for patients whose labor
associated with physical activity.

Hip fracture: diagnosis, treatment and rehabilitation

Hip fracture is a fairly common injury, accounting for about 5 percent of all fractures. The condition is a fracture of the upper part of the femur due to various reasons. Most often found in the fair sex. According to statistics, about 15 percent of women experience a similar injury at least once in their lives. The greatest risks are in older patients: one in five people with a hip fracture is over 60 years of age.

Anatomy

The hip joint is one of the key anchor points of the skeletal system. In addition, it is one of the largest joints in the body. The pelvic bone has an acetabulum to which the head of the femur joins. The connection is provided by the articular surface with a fossa and a pronounced femoral neck. It is located along an axis of 130 degrees in relation to the pelvis.

The femur itself is the largest tubular bone in the body. It has a cylindrical shape, slightly expanded from below. In the place where the neck of the femur passes into the body, there are peculiar elevations. They are called the large and small skewers. A large one is easy to detect during palpation, and a small one is localized in the back of the inside. The skewers are united by intertrochanteric ridge and line. The distal part, due to expansion, smoothly passes into the condyles, which have articular surfaces that connect to the tibia. In addition, this part articulates with the knee pads.

The occurrence of hip fractures is associated with a violation of biomechanics. So, the hip joint experiences combined loads that cause compression. However, with certain types of activity and in some situations, a specific sprain occurs, leading to a fracture of the femur. A typical example is a sideways fall at low speed from a standing position. This is how old people often fall. As a result, the hip hits the ground first, which increases the likelihood of a fracture at times. Statistics say that a fall to the side increases the risk of a broken bone by 15 times in men and 12 times in women. The data is relevant for people over 60–65 years of age.

Classification of hip fractures

There is a classification that determines the complexity and nature of the injury. Fracture of the femur is divided into the following types:

1. Oblique. This is the name of the injury in which the fault line is localized at an acute angle with respect to the middle of the bone.
2. Comminuted fracture of the femur. Accompanied by the appearance of bone fragments, which leads to damage to soft tissues. Such an injury is characterized by a high risk of possible complications.
3. Spiral. Occurs under the influence of torque. Typically, such a fracture of the femur is associated with the immobility of one bone in combination with the movement of the adjacent one.
4. Offset. This is an injury in which there is a displacement of bone fragments. They lose their correct position, and without timely treatment, a hip fracture will grow together with a violation of the anatomy of the lower extremities.

However, this classification does not provide a complete understanding of the diversity of hip fractures. Depending on the location and type of injury, the following types are distinguished:0005

1. Fractured upper thigh. Includes medial intra-articular fractures: subcapital, transcervical, basal. This group also includes neck fractures. Medial injuries can be adduction – leading to an expansion of the neck-diaphyseal angle, or cause a decrease in the angle. The latter are called abduction or valgus. This group includes trochanteric fractures affecting the upper thigh. These are intertrochanteric, pertrochanteric injuries, as well as fractures of the greater or lesser trochanter (isolated injuries of the trochanters).
2. Fracture of the diaphysis. This is a severe injury, expressed in violation of the integrity of the body of the femur. It can be accompanied by severe tissue damage, impressive blood loss and pain shock.
3. Intra-articular fracture of the femoral condyles. This is the name of the violation of the integrity of the condyles themselves or the distal end of the femur. All distal fractures are divided into 4 groups: supracondylar, intercondylar, condylar, distal epiphysis.

Causes of hip fractures

The factors that cause injury are not very diverse. Causes of hip fracture include:

1. Fall. Most often, a hip fracture occurs on the background of a fall. In this case, it is enough to lose balance while walking or just standing to damage the body or the neck of the femur. Usually the injury is associated with a fall on the side due to stumbling caused by the age of the patient.
2. Car accidents. Proximal fractures are often associated with road traffic accidents. Found in persons hit by a car or other vehicle at speed.
3. Sports. Injury with or without displacement of fragments may be the result of skiing, snowboarding, skating, rollerblading.

Injuries to the lower extremities are usually pathological. Thus, weakness of bone tissue is associated:

• with osteoporosis – a chronic disease that causes fragility of the femur;
• metabolic pathologies of bone tissue – imperfect osteogenesis, Paget’s disease, osteomalacia and others;
• high levels of homocysteine, an amino acid that destroys bone tissue;
• metastases from malignant tumors affecting the proximal region;
• infectious diseases localized in the area of ​​joints and bones;
• smoking – it increases the risk of developing osteoporosis.

Symptoms

The signs of a hip fracture are varied. They depend on the type and location of damage. Typically found:

1. Reduced joint mobility. A person cannot perform movement in the usual amplitude.
2. Shortening of the limb or turn of the leg to the side. A frequent sign of a violation of the integrity of the neck or other part of the femur. Detected with displaced damage.
3. Pain syndrome. With a hip fracture, pronounced pain is observed, which is not always stopped by the usual painkillers.
4. Stuck heel symptom. The patient cannot lift the straightened leg from the bed. The heel seems to “stick” and does not come off the surface.
5. Soft tissue edema. The damage also affects the muscles of the thigh.
6. Hemorrhage. Signs of subcutaneous hemorrhage may appear.
7. Bleeding. It is characteristic of open comminuted fractures and requires immediate surgical intervention.

With intra-articular hip fractures, pain is mild at rest, but increases with movement. On palpation, slight changes are found. Some patients endure pain and may not seek help for a long time. The trochanteric injury is accompanied by severe sharp pain at rest and intense pain during movement. It leads to a complete loss of mobility.

Diagnosis of hip fractures

In case of damage to the femoral shaft or other types of destruction of the femoral bone tissue, diagnostics are required to develop the correct treatment tactics. What methods are used:

1. X-ray. The method allows to obtain data on the type of injury, its localization, the presence and location of fragments. For more information in case of a hip fracture, an x-ray in several projections is recommended.
2. Magnetic resonance imaging. A type of examination used in a fracture of the femur in order to visualize the affected area in detail. Gives information about the condition of the bone and adjacent soft tissues. The method is based on the passage of sound waves through the body.
3. Computed tomography. A method that gives an understanding of the type of fracture in the upper thigh, the condition of the arteries, veins, nerves and muscle tissue.

If a femoral fracture is due to infection or chronic pathology, laboratory testing may be recommended. They will allow you to identify the intensity of the inflammatory process and report on the state of the body as a whole.

Treatment

Anesthetization and fixation of the injured limb is required immediately after the injury. Predominantly, a patient with a hip fracture requires surgical treatment. Further tactics are determined by the complexity and type of damage:

1. Traumatic damage to the neck. The complexity of the treatment of such a fracture of the femur is associated with slow healing. Often, even after a long time, the patient does not fully recover. Osteosynthesis increases the chances of recovery without consequences. Usually fixation with screws is used. According to the indications, it may be recommended to replace the damaged area with a titanium one. Hip arthroplasty is also used.
2. Trochanter injury. The therapy involves fixing the bone area with a dynamic screw or a movable plate. On average, healing takes 3 to 6 months. After the specified period, the screw is usually not removed. Such a hip fracture is typical for older people with a high risk of complications, so repeated surgery is dangerous.
3. In case of trauma to the femoral shaft. For fixation, surgical nails or plates are used. For recovery, the patient may be recommended traction (traction). Traction is indicated at the risk of displacement and for fixation of fragments.

In addition, conservative treatment is recommended. The victim is prescribed anti-inflammatory, painkillers, as well as chondroprotectors.

Recovery and rehabilitation

Rehabilitation plays an important role in the treatment of fractures of the upper femur or diaphysis. Fracture healing takes up to 6 months, but if the recovery program is not correct and the regimen is violated, the process may be delayed, and the risk of possible complications may increase. Rehabilitation methods:

1. Physical activity. It is recommended not to delay the exercises and start them immediately after the doctors approve the activity. The selected programs of physiotherapy exercises are the most effective. With walking, you should be more careful, gradually increasing the pace and frequency of walks.
2. Physiotherapy. Stimulates the healing of fractures of the femur, which are accompanied by damage to soft tissues. Effective for hip fractures with displacement and fragments. During the rehabilitation period, magnetotherapy, laser therapy, electrophoresis are indicated.
3. Vitamin and mineral intake. A good result is given by preparations with calcium, potassium and phosphorus in the composition.
4. Balanced nutrition. For bone healing, it is important to consume foods rich in calcium and phosphorus. General recovery is also based on adherence to the principles of proper nutrition.

Complications from improper treatment

Hip fracture is an injury with an increased risk of complications. Prolonged immobility, especially in old age, increases the likelihood of developing neurosis, dementia and psychopathic conditions. Without proper therapy, the risk of death in the first month after an injury is 10 percent, and in the first year after a hip fracture reaches 30 percent. That is why it is so important to follow all the recommendations and start moving as early as possible. Also among the possible complications of a hip fracture are:

• pulmonary embolism;
• hospital acquired pneumonia;
• increased risk of infection;
• reduced mobility and poor quality of life;
• high risk of recurrent hip fracture.

It is also possible to form a so-called “false joint”: the fracture does not grow together or grows together incorrectly.