The hip is a ball and socket joint surrounded by ligaments and tendons that hold it tightly together. These muscles connect the hips to other body structures, such as the thigh and pelvic bones. This then allows the hips to move with ease and be flexible. 

But of course, no matter how strong and tough these muscles are, they can still sustain injuries and develop disorders over time. One example of a hip condition that commonly affects competitive athletes is the snapping hip syndrome.

Read below to learn more about this condition and how an orthopedic specialist can effectively manage and treat it.

What is snapping hip syndrome?

Snapping hip syndrome, also known as dancer’s hip or coxa saltans, affects about 5% to 10% of the general population. 

It is a condition that occurs when a tendon (a tough tissue that connects muscles to bones) abnormally moves over the bony protrusion in the area during movement. It will then go back to its original place as you straighten your hip joints. 

As a result, individuals affected with this syndrome can hear an audible snapping or popping sound or sensation in the hip area. Snapping hip syndrome may be classified into several types, depending on the specific hip are it occurs:

What are the symptoms of snapping hip syndrome?

Snapping hip syndrome may start suddenly or develop over time. It will depend on the main cause of the condition and its type. But generally, most people with this disorder can experience one or more of the following symptoms:

Fortunately, most cases of snapping hips are painless and harmless. However, it should be addressed as soon as possible to avoid injuring the nearby hip structures or the tendon itself.

What causes snapping hip syndrome?

Most snapping hip syndromes happen as a result of hip muscle overuse or repetitive motion. This causes the affected tendon to become tight and more vulnerable to “snapping.” Individuals who are at risk include athletes that do repeated hip flexion and extension, such as ballet dancers, marathon runners, and gymnastics.

How do doctors diagnose snapping hip syndrome?

Orthopedic specialists can diagnose snapping hip syndrome through a complete medical history evaluation. They will also perform a series of physical examinations wherein you’ll be required to do simple activities that will recreate the snapping sound. 

Other diagnostic tests may include an X-ray or MRI to rule out other disorders that may be causing the popping sound. These imaging tests can also reveal other conditions or injuries in the surrounding area, such as bursitis.

What are the treatment options for snapping hip syndrome?

Generally, individuals do not seek a specialist for snapping hip syndrome unless there’s pain and discomfort. Typically, doctors recommend conservative treatment options first. Surgery will become an option if the affected hip is unresponsive to such methods.

Non-surgical treatment

Your orthopedic doctor will recommend you do one or more of the following to manage your snapping hip syndrome:

Surgical treatment for snapping hip syndrome

If symptoms persist or the condition worsens, your orthopedic specialist will need to recommend and perform surgery. They will discuss the best surgical technique that will meet your medical needs, such as hip arthroscopy or an open hip procedure.

Fortunately, it’s rare for snapping hip syndrome not to respond to medications and other conservative methods. So, it’s not common to treat this condition with surgery.

However, if the snapping sound comes from an injured or damaged cartilage. 

Orthopedic Center in Boca Raton

Orthopaedic Surgery Associates — Home of superior orthopedic medical care and treatment services

If you are experiencing hip pain or think you may need surgery to correct a problem with your hip joint, don’t hesitate to get in touch with Orthopaedic Surgery Associates

At Orthopaedic Surgery Associates, we offer comprehensive and individualized treatment for each patient’s specific needs. 

For hip conditions, our board-certified physicians have a range of treatment options, including hip arthroscopy

In addition to treatment for hip injuries, we also specialize in treating all other orthopedic conditions, including foot and ankle, knee, spine, and shoulder. 

Our team of orthopedic specialists are available at three convenient locations:

Questions? No problem—Contact us here!

 

The material contained on this site is for informational purposes only and DOES NOT CONSTITUTE THE PROVIDING OF MEDICAL ADVICE, and is not intended to be a substitute for independent professional medical judgment, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions or concerns you may have regarding your health.

Labrum is a ring of strong fibrocartilaginous tissue lining around the socket of the hip joint. Labrum serves many functions where it acts as shock absorber, lubricates the joint, and distributes the pressure equally. It holds the head of the femur in place and prevents the lateral and vertical movement of the femur head with in the joint. It also deepens the acetabular cavity and offers stability against femoral head translation.

Diagnosis

Labral tear may be caused by trauma, femoroacetabular impingement (FAI), hip hypermobility, dysplasia, and degeneration. It is one of the rare conditions and is common in athletes playing sports such as ice hockey, soccer, golf and ballet. Structural abnormalities may also cause hip labral tear. Patients may have hip pain, clicking and locking of joint and restricted range of motion. Patients may also experience dull pain on movement of hip joint that may not subside on rest. Hip labral tear is often diagnosed with symptoms, history, physical examination and radiological techniques. Magnetic resonance arthroscopy may be more appropriate for diagnosing hip labral tear.

Treatment

Your doctor may start with conservative treatment prescribing nonsteroidal anti-inflammatory drugs and advising you to rest. These methods may offer symptomatic relief while surgery is required to repair the torn labrum. Your doctor may perform arthroscopic surgery using fiber-optic camera and surgical instruments through the smaller incisions. Depending on the severity of tear, the damaged or torn labrum may be removed or may be sutured.

Hip dysplasia is a condition which is seen in infants and young children as a result of developmental problems in the hip joint. The femur (thigh bone) partially or completely slips out of the hip socket causing dislocation at the hip joint. It is most common in first born baby with family history of the disorder. The exact cause for hip dysplasia is not known. Genetic factors play an important role in causing this birth defect.

The common symptoms of hip dysplasia include:

In normal hip, the head of the femur (thigh bone) fits well into the socket (acetabulum) whereas in hip dysplasia, the socket and femoral head are not congruent because of their abnormal development. Patients with hip dysplasia may have undergone one or more hip operations during their childhood which might have caused considerable skeletal changes and scarring of the soft tissues. Secondary osteoarthritis may develop later in life which may cause pain and stiffness in the hip. This is an indication for total hip replacement surgery. During this surgery, your surgeon enlarges and prepares the socket to receive the acetabular component. A bone graft may sometimes be placed to recreate the roof of defective hip socket.

Chrondroitin sulphate and glucosamine are naturally occurring substances in the body that prevent degradation of cartilage and promote formation of new cartilage. Chrondroitin sulphate and glucosamine obtained from animal sources are available as over the counter products for arthritis. Apart from these various other nutritional supplements are also available such as calcium with magnesium and vitamin D as a combination, S-Adenosyl-Methionine and Methylsulfonylmethane.

These injections of steroids are given directly into the affected joint for severe pain when use of NSAIDs does not bring much relief. Steroids are very strong anti-inflammatory drugs and if used orally cause various side effects on other body systems. Local analgesics that prevent the sensation of pain are sometimes given along with steroids in the same shot to bring relief quickly.

Anti-rhuematic drugs include nonsteroidal anti-inflammatory drugs (NSAIDs), disease modifying anti-rheumatic drugs (DMARDs) and biologic agents. NSAIDs are anti-inflammatory agents that are devoid of steroidal components but effective in relieving the pain & inflammation. They are available in the form of pills, liquids and topical creams and are recommended to relieve arthritic pain. They are available as both over the counter drugs and prescription drugs.

Disease modifying anti-rheumatic drugs (DMARDs) considered as first line of agents for arthritis and these drugs retard the progression of joint damage. Biological agents are the antibodies developed using genetic engineering technology and they destroy the inflammatory agents causing arthritis.

Makoplasty® Robotic Knee Replacement

MAKOplasty® Partial Knee Resurfacing for Knee Osteoarthritis

The Procedure

MAKOplasty® Partial Knee Resurfacing is an innovative treatment option for adults living with early to midstage osteoarthritis (OA) in either the medial (inner), patellofemoral (top), or both compartments of the knee. It is powered by the RIO® Robotic Arm Interactive Orthopedic System, which allows for consistently reproducible precision in performing partial knee resurfacing.

The RIO® System empowers surgeons and hospitals to address the needs of a large and growing, yet currently underserved patient population. Patients who desire a restoration of lifestyle, minimized surgery, reduced pain and rapid recovery may benefit from MAKOplasty®.

During the procedure, the diseased portion of the knee is resurfaced, sparing the patient’s healthy bone and surrounding tissue. An implant is then secured in the joint to allow the knee to move smoothly again. MAKOplasty® Partial Knee Resurfacing can:

As a knee arthroplasty procedure, MAKOplasty® is typically covered by most Medicare-approved and private health insurers.

Dr. Elvis Grandic performing first robotic knee surgery in Palm Beach County Florida.

Robotic Arm Interactive Orthopedic System (RIO®)

The RIO® Robotic Arm Interactive Orthopedic System features three dimensional pre-surgical planning. During surgery, the RIO® provides the surgeon with real-time visual, tactile and auditory feedback to facilitate optimal joint resurfacing and implant positioning. It is this optimal placement that can result in more natural knee motion following surgery.

RIO® Features:

A knee replacement surgery is the last resort to relieve pain and restore function in knee damaged by arthritis or an injury when non-surgical treatments do not relieve the condition. The procedure involves replacing the damaged surfaces of the articulating bones with the artificial implant. Most of these implants wear with use. Thus the risk of need for revision surgery is high in young and active people if the implant has to last the lifetime of the patient. The life of the implant can be extended by precise alignment of the implant and this can be achieved by the use of computer navigation for total knee replacement surgery.

Computer navigation provides the surgeon with the real time 3-D images of the mapped patient’s knee and the surgical instruments during surgery. The data for the images is provided by the infrared sensors fixed to the bones of the knee and the surgical instruments. Their position is tracked by an infrared camera placed above the surgical table connected to the computer. The computer than generates the real time images with the help of the appropriate software to  guide the surgeon to precisely resurface and cut the bones of the knee and fix the implant precisely & accurately according to the pre-operative surgical plan. Thus the surgery is done by the surgeon only. Computer navigation is just a tool to guide the surgeon and improve the outcome of the surgery. It cannot replace the skills of an experienced surgeon.

Femoroacetabular impingement (FAI) is a condition where there is too much friction in the hip joint from bony irregularities causing pain and decreased range of hip motion. The femoral head and acetabulum rub against each other creating damage and pain to the hip joint. The damage can occur to the articular cartilage (the smooth white surface of the ball or socket) or the labral tissue (the lining of the edge of the socket) during normal movement of the hip. The articular cartilage or labral tissue can fray or tear after repeated friction. Over time, more cartilage and labrum is lost until eventually the femur bone and acetabulum bone impact on one other. Bone on bone friction is commonly referred to as Osteoarthritis.

FAI Impingement Types

FAI impingement generally occurs as two forms: Cam and Pincer.

CAM Impingement 
The Cam form of impingement is when the femoral head and neck are not perfectly round, most commonly due to excess bone that has formed. This lack of roundness and excess bone causes abnormal contact between the surfaces.

PINCER Impingement
The Pincer form of impingement is when the socket or acetabulum rim has overgrown and is too deep. It covers too much of the femoral head resulting in the labral cartilage being pinched. The Pincer form of impingement may also be caused when the hip socket is abnormally angled backwards causing abnormal impact between the femoral head and the rim of the acetabulum.

Most diagnoses of FAI include a combination of the Cam and Pincer forms.

Symptoms of FAI

Symptoms of femoroacetabular impingement can include the following:

Risk Factors

A risk factor is something that is likely to increase a person’s chance of developing a disease or condition. Risk factors for developing femoroacetabular impingement may include the following:

Diagnosis

Hip conditions should be evaluated by an Orthopedic hip surgeon for proper diagnosis and treatment. Such as:

Treatment Options

Conservative Treatment (Non-Surgical) Measures

Conservative treatment options refer to management of the problem without surgery. Non-surgical management of FAI will probably not change the underlying abnormal biomechanics of the hip causing the FAI but may offer pain relief and improved mobility.

Surgical Treatment

Hip arthroscopy to repair femoroacetabular impingement is indicated when conservative treatment measures fail to provide relief to the patient. Hip arthroscopy is a surgical procedure in which an arthroscope is inserted into the hip joint to assess and repair damage to the hip. Hip arthroscopy is performed in a hospital operating room under general or regional anesthesia depending on you and your surgeon’s preference.

This surgery is usually performed as day surgery or outpatient surgery, enabling the patient to go home the same day. The arthroscope used in hip arthroscopy is a small fiber-optic viewing instrument made up of a tiny lens, light source and video camera. The surgical instruments used in arthroscopic surgery are very small (only 3 or 4 mm in diameter), but appear much larger when viewed through an arthroscope.

The television camera attached to the arthroscope displays the image of the joint on a television screen, allowing the surgeon to look throughout the hip joint. The surgeon can then determine the amount or type of injury, and then repair or correct the problem as necessary.

In arthroscopic repair of FAI, your surgeon may perform the following procedures:

  1. Chondroplasty: This refers to surgery to repair torn cartilage or a torn labrum. Sutures are used to reattach the torn labrum or cartilage.

  2. Microfracture: This involves drilling holes into bare bone where cartilage is missing to promote the formation of new cartilage.

  3. Labral/Cartilage debridement:</strong> This type of debridement refers to cutting out and removing pieces of torn or frayed labrum or cartilage.

  4. FAI decompression: This involves removing any pressure areas, such as bony bumps, causing the impingement.

  5. Osteoplasty: This refers to a surgical procedure to modify or alter the shape of a bone

For FAI surgery, your surgeon will use a special instrument called a shaver to cut away or debride any frayed cartilage. If the labrum is torn, your surgeon will use sutures to preserve and reattach the labrum.

Any bony bumps present contributing to the impingement will also be shaved away and smoothed. Your surgeon may drill holes in bone that has no cartilage covering it. This technique is called microfracture and stimulates the formation of new cartilage.

Once your surgeon is satisfied with the results the instruments and arthroscope are removed from the portals. The portals (incisions) are then closed by suturing or by tape.

Arthroscopic repair of FAI, offers several advantages to the patients and they include:

Risk And Complications

As with any major surgery there are potential risks involved. The decision to proceed with the surgery is made because the advantages of surgery outweigh the potential disadvantages. It is important that you are informed of these risks before the surgery takes place. Complications can be medical (general) or specific to hip arthroscopy surgery.

Read more about general risk and complications with any surgery and hip surgery here.

Complications are rare after hip arthroscopy surgery, but unexpected events can follow any operation. Please talk to your surgeon for more information on femoroacetabular impingement.

Knee replacements are preformed through an incision on the front of the knee. There are some different ways to handle the soft tissue and extensor mechanism of the knee which are discussed below. Each approach has advantages and disadvantages.

Knee Replacement Approach Types

Medial Parapatellar Approach
A medial parapatellar incision involves cutting the quadriceps tendon above the knee cap (patella) and around the inside (medial) of the knee cap. The tendon is then repaired at the end of the procedure. The idea behind cutting the tendon is that the tendon might heal better than cutting into the muscle belly of the VMO. The patella is typically flipped during this approach to gain access to the knee joint which may or may not affect the knee rehab in the short term.

Mid-Vastus Approach
A mid-vastus approach does not cut the quadriceps tendon but instead cuts into the VMO muscle belly and around the inside of the knee cap. The idea behind leaving a large portion of the VMO attached to the quadriceps is that the VMO muscle may help patellar tracking and knee extension strength. The muscle belly is repaired at the end of the procedure. The patella may or may not be flipped during this approach.

Sub-Vastus Approach
The sub-vastus approach elevates the VMO muscle instead of cutting into it. The incision then extends around the inside of the knee cap. The patella is typically not flipped with this approach. This approach is difficult in muscular patients with large VMO muscles and generally makes the operation a little harder. Theoretically, the patella tracking and quadriceps muscle strength may be temporarily improved with this approach in the short term, but there are no long term differences months later.

Quad-Sparing Approach
The quad-sparing approach cuts just the inside of the knee cap. This approach requires special side cutting instruments. There is definitely a steep learning curve regarding the use of these instruments and many physicians (including myself) worry about the accuracy of the bone cuts and limb alignment with these side cutting instruments. This approach has received some press, but has not caught on among orthopedic surgeons.

Lateral parapatellar Approach
The lateral parapatellar approach is a uncommon approach where the incision extends around the outside (lateral) of the knee cap. Some surgeons will use this approach for severe valgus deformities.

Good results after a total knee replacement can be achieved with any of the above approaches. Patients should allow the surgeon to perform the approach the surgeon is most comfortable with.

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