Torn Labrum

The diagram shows how the labrum can tear away from the acetabulum. This torn cartilage can get pinched in the joint or disconnect entirely and become a loose body within the joint.

Your hip is a ball-and-socket-joint: the femoral head forms the ball and the acetabulum, which is part of the pelvic bone, forms the socket. The labrum of the hip is a cuff of thick fibrocartilage tissue that surrounds the hip socket. The labrum helps to support the hip joint and provide stability.

A labral tear occurs when a piece of the labrum cartilage becomes pinched between the femoral head and the acetabulum causing pain and catching sensations. Hip labral tears can result from either degeneration or anatomical abnormalities. Hip labral tears usually affect active adults ages 20-40.

– Degeneration: Degenerative tears occur with repetitive stress, such as repetitive pivoting and hip flexion.
– Anatomical Abnormalities: The most common anatomical abnormality to cause hip labral tears is called Femoral Acetabular Impingement (FAI) (for more information on FAI please see the FAI section of this page). The extra boney structure which defines FAI reduces the amount of space within the joint, pinching labrum between the acetabulum and femoral head.

Labral tears are commonly seen in athletes who play contact sports such as; football, basketball, field hockey, and soccer.

Symptoms
– Loss of range of motion
– Inability/weakness with moving leg across the body
– Inability/weakness with lifting leg
– Pain in the groin
– Pinching feeling deep in the joint
– Catching/snapping sensation with specific motions
– ‘C’ sign pain- pain in the cross section of the front and outer side of the thigh.
– Sensation of instability/looseness
– Pain with:
– Getting into and out of the car
– Going from a sitting to stand position
– Sleeping on the affected side
– Twisting and turning
– Crossing legs while sitting
– Daily activity

If your symptoms last longer than 2 weeks you should consult your primary doctor for a referral.

Your Appointment with Dr. McMillan

During your appointment your Dr. McMillan will perform a physical exam to test your hip’s range of motion and your leg strength. You may also get X-rays in the office and set up an MRI to diagnose the cause of your pain. A specific type of MRI called an Arthrogram is used to diagnose labral tears. During the arthrogram the radiologist will inject dye into your hip joint making it easier to find small abnormalities within the joint. Once the results of your MRI come back, Dr. McMillan will map out your treatment options and help you decide thes course of action that is best for you.

Treatment

Dr. McMillan examining a patient for a labral tear.

Non-surgical:
– Rest
– Medication: Non-steroidal anti-inflammatory medication to minimize swelling and pain.
– Physical Therapy: Strengthening your upper leg will help relieve pain and prevent further injury. You will also work on stretches to help regaining mobility.
– Injections: If the other non-surgical treatments fail Dr. McMillan can use injections to help reduce pain.
– Steroid Injection (Cortisone): Has been proven to be very effective at reducing inflammation and pain.
– Platelet Rich Plasma (PRP): Your own blood is used to extract plasma platelets, which are then injected into your hip joint. These platelets stimulate the body to repair itself.

Surgical:
If non-surgical methods fail to improve pain Dr. McMillan will discuss surgery as an option. Each patient and tear is different, however most tears can be treated arthroscopically. For more information of Arthroscopic surgery please see ‘What is Arthroscopic surgery?”

Loose Bodies

The diagram shows loose bodies within the hip joint.

Your hip is a ball-and-socket-joint: the femoral head forms the ball and the acetabulm, which is part of the pelvic bone, forms the socket. The labrum of the hip is a cuff of thick fibrocartilage tissue that surrounds the hip socket. The labrum helps to support the hip joint and provide stability. Surrounding the hip joint are ligaments, tendons, and muscles that control hip movement.

Loose bodies are pieces of cartilage or bone that are floating within the joint. In young adults they are most often the result of sports injuries or trauma. In older adults they are the result of the degeneration that occurs in many types of arthritis.

Loose bodies are often seen in athletes who play contact sports such as; football, basketball, field hockey, and soccer.

Symptoms
– Catching/snapping/crunching sensation deep in the joint
– Joint instability
– Loss of range of motion
– Loss of strength
– Pain deep the joint and/or groin
– Pain with:
– Sleeping on the affected side
– Twisting and turning
– Crossing legs while sitting
– Daily activity

If your symptoms last longer than 2 weeks you should consult your primary doctor for a referral.

Your Appointment with Dr. McMillan

During your appointment your Dr. McMillan will perform a physical exam to test your hip’s range of motion and your leg strength. You may also get X-rays in the office and set up an MRI to diagnose the cause of your pain. Once the results of your MRI come back, Dr. McMillan will map out your treatment options and help you decide the course of action that is best for you.

Treatment

Dr. McMillan examining a patient for loose bodies.

Non-surgical:
– Rest
– Medication: Non-steroidal anti-inflammatory medication to minimize swelling and pain.
– Physical Therapy: Strengthening your upper leg will help relieve pain and prevent further injury. You will also work on stretches to help regaining mobility.
– Injections: If the other non-surgical treatments fail Dr. McMillan can use injections to help reduce pain.
– Steroid Injection (Cortisone): Has been proven to be very effective at reducing inflammation and pain.
– Platelet Rich Plasma (PRP): Your own blood is used to extract plasma platelets, which are then injected into your hip joint. These platelets stimulate the body to repair itself.

Surgical:
If non-surgical methods fail to improve pain or the joint is locked and unable to move Dr. McMillan will discuss surgery as an option. Each patient and case is different, but most loose bodies can be removed arthroscopically. For more information of Arthroscopic surgery please see ‘What is Arthroscopic surgery?”

Snapping Hip Syndrome

The diagram depicts the IT band snapping over the greater trochanter.

Your hip is a ball-and-socket-joint: the femoral head forms the ball and the acetabulm, which is part of the pelvic bone, forms the socket. The labrum of the hip is a cuff of thick fibrocartilage tissue that surrounds the hip socket. The labrum helps to support the hip joint and provide stability. Surrounding the hip joint are ligaments, tendons, and muscles that control hip movement.

Snapping hip syndrome, also known as ‘dancer’s hip,’ occurs when tendons and muscles slide/snap over knobs in the hip joint. It is often caused by tightness in the tendons and muscle imbalance in the structures surrounding the hip. It is often associated with young athletes due to tightness in the hip muscles caused by growth spurts. Snapping hip can occur in different areas of the hip:

– Outside the Hip: The most common site for snapping hip occurs is outside the hip, where the iliotibial band (IT band) passes over the a portion of the femur called greater trochanter.
– Front of the Hip: Snapping hip that occurs in the front of the hip is caused by the iliopsoas tendon catching on the front of the pelvis bone.
– Back of the Hip: Snapping hip that occurs in the back of the hip is a result of the hamstring tendon catching on the ischial tuberosity (sitting bone).
– Cartilage Problems: A torn labrum can cause a snapping/popping sensation and damaged cartilage can loosen and float into the hip joint, this type of snapping hip causes pain and can be debilitating.

Snapping hip syndrome is commonly seen in: Dancers and gymnasts.

Symptoms
– Snapping sound
– Catching/snapping/popping sensation
– Pain

If your symptoms last longer than 2 weeks and interfere with daily activity you should consult your primary doctor for a referral.

Your Appointment with Dr. McMillan

During your appointment your Dr. McMillan will perform a physical exam to test your hip’s range of motion and your leg strength. You may also get X-rays in the office and set up an MRI to diagnose the cause of your pain. Once the results of your MRI come back, Dr. McMillan will map out your treatment options and help you decide the course of action that is best for you.

Treatment

Dr. McMillan examining a patient for snapping hip.

Non-surgical:
– Rest
– Medication: Non-steroidal anti-inflammatory medication to minimize swelling and pain.
– Physical Therapy: Strengthening, stretching, and aligning the joint will be the focus of physical therapy.
– Injections: If the other non-surgical treatments fail Dr. McMillan can use injections to help reduce pain.
– Steroid Injection (Cortisone): Has been proven to be very effective at reducing inflammation and pain.
– Platelet Rich Plasma (PRP): Your own blood is used to extract plasma platelet, which are then injected into your hip joint. These platelets stimulate the body to repair itself.

Surgical:
Snapping hip syndrome rarely requires surgery, however, if conservative treatment fails Dr. McMillan may discuss surgery as an option. Each patient and case is different, but snapping hip can usually be treated arthroscopically. For more information of Arthroscopic surgery please see ‘What is Arthroscopic surgery?”

FAI

Your hip is a ball-and-socket-joint: the femoral head forms the ball and the acetabulm, which is part of the pelvic bone, forms the socket. Femoral Acetabular Impingement (FAI) is a congenital abnormality of the bone, in which there is overgrowth of the bone. Overgrowth of the acetabulm (hip socket) is called a ‘Pincer’ impingement, overgrowth of the femoral head is called a ‘CAM’ impingement, ‘mixed’ is the presents of both types of impingements.

The diagram depicts the three types of Femoroacetabular Impingement (FAI).The presents of FAI in some individuals can go unnoticed indefinitely, however, when symptoms develop its usually an indication of damage to the joint structure. Extra bone growth reduces space within the joint causing structures to rub or grind against each other, because of this people with FAI are more likely to experience loose bodies, labral tears, snapping hip syndrome, and arthritis.

Symptoms
– Loss of range of motion
– Inability/weakness with moving leg across the body
– Inability/weakness with lifting leg
– Pain in the groin
– Pinching feeling deep in the joint
– Catching/snapping sensation with specific motions
– Pain with:
– Getting into and out of the car
– Going from a sitting to stand position
– Sleeping on the affected side
– Twisting and turning
– Squatting
– Crossing legs while sitting
– Daily activity

If your symptoms last longer than 2 weeks and interfere with daily activity you should consult your primary doctor for a referral.

Your Appointment with Dr. McMillan

During your appointment your Dr. McMillan will perform a physical exam to test your hip’s range of motion and your leg strength. You may also get X-rays in the office and set up an MRI and CT scan to diagnose the cause of your pain. CT scans provide more detail than X-ray, and will help Dr. McMillan determine the extent of bone growth abnormality. Once the results of your MRI and CT scan come back, Dr. McMillan will map out your treatment options and help you decide the course of action that is best for you.

Treatment
Dr. McMillan examining a patient for FAI.

Non-surgical:
– Rest
– Medication: Non-steroidal anti-inflammatory medication to minimize swelling and pain.
– Physical Therapy: Strengthening your upper leg will help relieve pain and reduce stress on the injured structure. You will also work on stretches to help regaining mobility.
– Injections: If the other non-surgical treatments fail Dr. McMillan can use injections to help reduce pain.
– Steroid Injection (Cortisone): Has been proven to be very effective at reducing inflammation and pain.
– Platelet Rich Plasma (PRP): Your own blood is used to extract plasma plateletS, which are then injected into your hip joint. These platelets stimulate the body to repair itself.

Surgical:

If non-surgical methods fail to improve pain Dr. McMillan will discuss surgery as an option. Each patient and case is different, but FAI can usually be treated arthroscopically. For more information on Arthroscopic surgery please see ‘What is Arthroscopic surgery?

Arthritis

The diagram compares a normal hip to an arthritic hip.

Your hip is a ball-and-socket-joint: the femoral head forms the ball and the acetabulm, which is part of the pelvic bone, forms the socket. The labrum of the hip is a cuff of thick fibrocartilage tissue that surrounds the hip socket. The labrum helps to support the hip joint and provide stability. Surrounding the hip joint are ligaments, tendons, and muscles that control hip movement. Just like every other joint, your hip(s) can develop arthritis. There are two types of arthritis that can affect the your hip(s):
– Osteoarthritis: Osteoarthritis, also known as ‘wear and tear arthritis,’ is a condition that destroys the cartilage covering the bones, which allows the bones rub against each other causing pain. Osteoarthritis usually affects individuals over 50 or those with a history of damage to the hip cartilage.
– Rheumatoid Arthritis (RA): RA is an autoimmune disease which forces your immune system to attack normal tissues in your joints like synovium, the lining of your joints, cartilage, and bone. It causes inflammation which results in pain and stiffness in the joint.

Symptoms
– Loss of range of motion
– Pain in the groin, outer thigh, or buttocks
– Dull achey pain which is usually worse in the morning
– Pain with:
– Getting into and out of the car
– Going from a sitting to stand position
– Sleeping on the affected side
– Twisting and turning
– Crossing legs while sitting
– Daily activity

If your symptoms last longer than 2 weeks and interfere with daily activity you should consult your primary doctor for a referral.

Your Appointment with Dr. McMillan

During your appointment your Dr. McMillan will perform a physical exam to test your hip’s range of motion and your leg strength. You may also get X-rays in the office and set up an MRI to diagnose the cause of your pain. Once the results of your MRI come back, Dr. McMillan will map out your treatment options and help you decide the course of action that is best for you.

Treatment

Dr. McMillan examining a patient for loose bodies.

Non-surgical:

– Rest
– Medication: Non-steroidal anti-inflammatory medication to minimize swelling and pain.

– Physical Therapy: Strengthening your upper leg will help relieve pain and reduce stress on the injured structure. You will also work on stretches to help regaining mobility.

– Injections: If the other non-surgical treatments fail Dr. McMillan can use steroid injections (Cortisone) to reduce pain.

Surgical:
If non-surgical methods fail to improve pain Dr. McMillan will discuss surgery as an option. Each patient is different so surgical plans very greatly depending on your needs and stage of arthritis.