Bursitis probably the most common hip joint condition presenting to a doctor's office. When it does not respond to traditional simple measures such as a modification of activities or a trial of anti-inflammatory medicines (e.g. Motrin, Naprosyn, Volterin, Daypro, etc.), then many times it is appropriate to consider referral to an orthopedic surgeon for better delineation of the problem. The suffix "itis" in medicine refers to an inflammation (irritation). A "bursa" is a fibrous covering overlying a bone. Hence, bursitis is an irritative condition overlying the bones in the hip (typically the part of the femur known as the Greater Trochanter). Frequently an injection with a cortisone type preparation will be tried to see if the symptoms are alleviated. Many times, however, the focus of attention may be to determine if some other condition as listed below exists which might require more specialized treatment or even surgery.
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Avascular Necrosis (Aseptic Necrosis) of the hip represents a condition where the hip has at least temporarily lost the critical blood supply to the ball part (femoral head) of the hip. This can cause a condition where the bone begins to collapse at this weakened site and then arthritis can begin. This is the condition many people identify with Bo Jackson who eventually underwent hip replacement surgery for the treatment of this disorder. There are several factors which have been statistically identified with this condition, but for the vast majority of patients there is no known cause (idiopathic).
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Arthritis is a gradual wearing down of the smooth gliding surfaces of the hip joint. When this occurs, raw bone becomes exposed within the hip joint which becomes painful with activity. This may have occurred due to a variety of reasons but frequently the end result is the same, increasingly persistent pain and decreasing activity level. First line treatments include modification of activity and use of an anti-inflammatory medicine (e.g. Motrin, Naprosyn, Daypro, Volterin, etc.) or perhaps Tylenol type products. Sensitivity of the stomach and intestines many times makes prolonged use of the anti-inflammatory medicines difficult. When the condition becomes particularly severe, then surgery is indicated. The most common procedure is Total Hip Replacement which aims at resurfacing both the cup (acetabulum) and ball (femoral head) surfaces. A frequent misconception of patients is that they are too old for this type of surgery since it is extensive. However, the vast majority of patients undergoing hip replacement surgery are easily within the retirement age group and usually do excellent.