Hip pain and hip injury
Duke is a nationally ranked leader in the treatment of hip pain, hip injuries and hip preservation for patients of every age. We perform more than 1,000 hip replacement surgeries each year, and often correct unsuccessful surgeries performed elsewhere. Our goal is to offer you relief from the pain and disability often associated with hip injuries and deteriorating hip conditions.
National leader in hip care
Debilitating hip pain needs an accurate diagnosis and prompt treatment. You’ll work with teams of specialists whose goal is to minimize your pain and return you to everyday living as soon as possible.
Our doctors pioneered game-changing techniques to relieve hip pain and dysfunction caused by arthritis, bursitis, fractures and labral tears resulting from femoroacetabular impingement (FAI) and hip dysplasia. We’re nationally recognized for our comprehensive treatment approach to less common conditions such as avascular necrosis, as well as conditions typically seen in children and adolescents, including slipped capital femoral epiphysis (occurs when the upper part of the thighbone shifts, which can weaken the hip joint), perthes disease (a hip joint disorder), and sports hernia (also known as athletic pubalgia). We specialize in the preservation of hip bones and joints in patients of all ages, and our patients benefit from our ongoing research to find new ways to prevent hip deterioration.
Choose Duke Orthopaedics because we offer:
- Teamwork that yields the best care. You’ll work with a team of physicians, physician assistants, nurses, anesthesiologists, physical therapists, occupational therapists, and patient resource managers who devote themselves to your well being. You’ll be treated compassionately and holistically, with the goal of returning to your optimal function and enhanced quality of life.
- Doctor expertise. Our fellowship-trained orthopaedic surgeons and doctors have undergone additional years of specialized training. We treat a high volume of patients with hip conditions, and perform over 1,000 hip replacements each year. Our orthopaedic program is consistently ranked as one of the top in the country by U.S. News & World Report.
- Surgical advances not widely available. We offer minimally invasive surgical approaches, as well as surgically precise, computer-assisted hip replacement. Our surgeons are among a select few in North Carolina to perform complicated hip surgeries, such as periacetabular osteotomy for hip dysplasia. Our vast experience means you recover faster and experience less pain.
- Advanced care for young hips. We are one of the few centers to offer the full array of hip preservation treatments for younger patients with painful and debilitating hip conditions.
- A history of innovation. We pioneered free vascularized bone graft, a surgical approach to treat avascular necrosis, the death of bone in the hip joint. We train doctors around the country to perform free vascularized bone graft, which eases pain associated with avascular necrosis and can restore patients to normal function.
HIP PAIN AND HIP INJURIES
In addition to conservative treatments for hip pain, such as medication and physical therapy, Duke offers a full array of effective surgical procedures.
A minimally invasive procedure in which surgeons make small incisions to repair tears of the labral (the cushioning structure along the rim of the hip socket), trim torn articular cartilage, or reshape bone deformities in patients with femoroacetabular impingement (FAI). Special equipment applies traction to your hip to safely separate the ball and socket of the hip during the procedure.
Our surgeons use the same specialized equipment used for hip arthoscopy -- without the traction -- to repair tears of the tendons of the hip. These include the gluteus medius and minimus, and hamstring tears. Gluteus medius and minimus, or abductor, tears are a common cause of hip bursitis that does not improve with physical therapy and an injection.
Our surgeons are among the only specialists in North Carolina to correct hip dysplasia by cutting the bone to free the hip socket from the pelvis and turning the socket to change its orientation. PAO relieves hip pain while preserving the hip joint for patients with acetabular dysplasia. When done early in the course of hip dysplasia, PAO has been shown to preserve hip function for many years. We are one of the few centers in the nation which can combine the techniques of PAO and hip arthroscopy when needed.
Treats avascular necrosis. A connection is made between the outside of the thigh bone and the area of the femoral head or ball of the hip socket that contains dead bone. The layer of dead bone is then removed, relieving pressure on the bone and reduces pain. The bone will have room to form new blood vessels, which promotes the production of new bone.
When necessary, the connection made to the femoral head by core decompression is grafted or filled with bone to support the femoral head. Dead bone is removed from the hip to treat avascular necrosis, and replaced with a healthy part of the fibula bone from your leg, A new blood supply is created to ensure the bone remains healthy. Our surgeons have performed more than 3,500 free-vascularized fibula since the surgery was developed and pioneered at Duke. We train the doctors who perform it elsewhere. This unparalleled volume means better outcomes for you.
In a total hip replacement surgery, also known as a total hip arthroplasty, your surgeon replaces cartilage that has deteriorated beyond repair with specialized hip implants. We offer numerous approaches to total hip replacement surgery, including the traditional posterior hip replacement, as well as the rarer anterior hip replacement, which is linked with less pain and an easier recovery. Learn more about hip replacement surgery.
Surgeons shape the cap of the femur to accept the hip resurfacing implant, which allows more of the original femur bone to be preserved. This procedure preserves bone in the hip bones as compared with total hip replacement. Current data suggests that hip resurfacing is best limited to use in younger large boned patients (usually males).
This approach to hip replacement surgery and hip resurfacing uses GPS-like technology to guide the placement of surgical instruments and artificial hip joints. Studies suggest the technology diminishes patients’ blood loss and the risk of a dangerous blood clot.
In select circumstances, hip labral tears from femoroacetabular impingement (FAI) are treated with an open surgical approach. This technique is particularly helpful in adult patients with complex deformaties. It is also used in children with slipped capital femoral epiphysis (commonly referred to as a SCFE).
HIP PAIN AND HIP INJURIES
In addition to standard X-rays, MRI and CT scans are used to identify complex problems in the hip joint.
Dye is placed in the hip joint to enhance MRI images. Our orthopaedic surgeons and radiologists have collaborated to develop a specialized sequence of magnetic resonance arthrogram (MRA) images that help to diagnose hip dysplasia.
Intra-articular injections may contain a numbing agent and steroid medications to diagnose and treat hip pain.