Cartilage damage to the hip
General
The structure of the cartilage usually ensures painless and optimal movement in the joint. It enables the two bones involved, the thigh and the hip, to slide back and forth and perform everyday movements such as climbing stairs and running without any problems. Without the cartilage, these movements would be unthinkable.
Bald cartilage describes the condition when there is no more cartilage. For more information, read the article at: Bald cartilage - is it dangerous?
The hip joint is formed from the head of the Thighbone (Head femoris) and the Acetabulum (Acetabulum). Both structures are covered with cartilage. The cartilage structure and synovial fluid ensure that there is no friction or pain when moving. If there is cartilage damage, so some kind Tear in the cartilage tissue, pain may occur that may require treatment. It can be a small crack, but also under certain circumstances significantly larger dimensions (up to 2 € each). The problem with cartilage damage is that the cartilage does not, like most other structures in our body, have one own blood or nerve supply but is largely supplied by the surrounding structures. If cartilage tissue is damaged, there is one the body's own regeneration mostly for this reason only possible to a very limited extent.
Causes of Hip Cartilage Damage
Because the cartilage tissue indispensable for our joints If a smooth, painless movement is to be carried out, it is not surprising that the slightest disturbance in this optimal construction results in complaints that require remedial action.
The reasons for one Cartilage damage cannot always be clearly diagnosed. This can damage the cartilage layer that forms the cartilage several causes to have.
The causes can be found in acquired and congenital causes organize. Congenital causes include anatomical factors such as different leg lengths and X- or If one.
Acquired causes include traumatic, as well as inflammatory processes. A previous accident is typical for such abrasion of the cartilage tissue, but also wrong, excessive loads can cause such damage as a result. If the joint is a sudden, very heavy stress exposed, for example in a car accident or when Sports, the cartilage can be damaged. However, these processes do not necessarily have to happen suddenly, they can vary develop over many years. Years of competitive sport can damage the cartilage tissue. Sometimes a piece of cartilage splintered off, which in turn led to pain Restrictions on movement can lead. Risk factors for developing chronic joint disease, such as arthritis, are typically Obesity, and certain occupational groups who put too much stress on their joints. Often the damage is due to one long-term exposure are to be attributed to a larger area than in the case of damage after a traumatic event (Traffic accident, sports injury).
Cartilage damage can also occur when Metabolic disorders how gout or infections caused by certain bacteria have preceded. It is not absolutely necessary that the Infection in the hip joint Template. Rheumatic diseases, as the Rheumatoid arthritis can also be the reason for the cartilage damage in the hip joint.
If cartilage damage occurs in the hip joint, they also play Influencing factors such as age and individual stress a crucial role for the joint. In some cases, the damage can be unilateral, but it presents itself mostly on both hip joints. The diagnosis is often made in old age between 40 and 50 years posed.
Appointment with a hip expert?
I would be happy to advise you!
Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
But now enough is indicated ;-)
The hip joint is one of the joints that are exposed to the greatest stress.
The treatment of the hip (e.g. hip arthrosis, hip impingement, etc.) therefore requires a lot of experience.
I treat all hip diseases with a focus on conservative methods.
The aim of any treatment is treatment without surgery.
Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.
You can find me in:
- Lumedis - your orthopedic surgeon
Kaiserstrasse 14
60311 Frankfurt am Main
Directly to the online appointment arrangement
Unfortunately, it is currently only possible to make an appointment with private health insurers. I hope for your understanding!
Further information about myself can be found at Dr. Nicolas Gumpert
Illustration of cartilage damage using the knee joint as an example
- Articular cartilage
(hyaline cartilage) -
Cartilago articularis - Cartilage remodeling zone
in bones -
Zona ossificationis - Joint body (articular gnar
of the femur) -
Femoral condyle - Femur -
Femur - Articular cartilage -
Cartilago articularis - Outer band -
Ligamentum collaterale fibulare - Outer meniscus -
Lateral meniscus - Inner meniscus -
Meniscus medialis - Fibula - Fibula
- Shin - Tibia
You can find an overview of all Dr-Gumpert images at: medical illustrations
Symptoms
The symptoms of a Cartilage damage in the hip joint are typical of joint damage in this area. These include:
- Pain, which is common depending on load and position are
- a "Crack" in the joint, with or without associated pain
- Pain at night
- a Feeling of instability of the hip joint
- Restrictions on movement in the joint
- Swelling and other signs of inflammation such as warming and redness.
The complaints occur if they have chronic illness is, often periodically. In a few weeks or months they will be Pain extremely severe, whereas in other weeks the symptoms are easily tolerable. If such or similar symptoms are present, it should in any case consulted the attending physician so that the problem can be identified and possibly rectified.
diagnosis
If cartilage damage is suspected in the hip joint, a Specialist in orthopedics or general medicine. For the diagnosis is a detailed anamnesis important to the person concerned, as this is the only way to rule out certain diseases. The decisive factor here is whether the pain is in directly related to an accident and when or how long the pain has been occurring. The doctor will do some tests and examine stability and freedom of movement.
You can also X-rays However, the cartilage tissue cannot be assessed on this. Only other diseases can be excluded.
Therefore, there is usually a MRI of the hip (Magnetic resonance imaging) carried out. If necessary, a Contrast media injected into the hip for a more accurate assessment of damage.
Read more about this topic at: MRI of the hip
To the final diagnosis however, in most cases it is one Arthroscopy necessary. According to the International Cartilage Repair Society there are different degrees of severity for the classification of cartilage damage:
Grade 0: (normal) healthy cartilage tissue
Grade 1: Of the cartilage Has soft spots or blisters
Grade 2: Small damages of the cartilage are visible
Grade 3: Damage with gap formation (in more than 50% of the cartilage tissue in the joint)
Grade 4: The damage to the cartilage is going down to the bone below and expose it.
After this classification, the appropriate therapy for the respective patient is determined.
therapy
The right therapy for the cartilage damage in the hip joint depends crucially on the given circumstances from. So can the cartilage tissue in children regenerate relatively wellas long as the damage does not exceed a certain extent. The adult cartilage hardly regenerates itself, which is why in these cases mostly opted for surgery becomes. If the damage is very minor, it may be possible to wait for a surgical intervention and start a non-surgical therapy. Which includes physiotherapeutic and physical treatment, as well as pain-relieving drug therapy.
Since cartilage damage in the hip joint is proportional often with a high load of the Joint correlate, it is paramount to eliminate this burden, if possible. This affects certain movements, as well as loads that attributed to obesity are. If you are overweight, you should reduced to normal weight as soon as possible become. Every step would otherwise Put unnecessary stress on cartilage. Therefore, nutrition and sports advice should be given under certain circumstances. insoles for sports and everyday shoes can also reduce the stress on the joint somewhat. Long standing, heavy lifting, and walking on uneven ground should also be avoided. The Taking pain relievers and anti-inflammatory drugs (NSAIDs) can also help. If the cartilage damage is minor and the external circumstances of the person concerned (age, concomitant diseases, etc.) permit, this can be Therapy quite promising be.
Still, in most cases of severe cartilage damage is one Operation in the hip joint cannot be avoided. The operation is usually minimally invasive Hip joint arthroscopy. There are several methods that can be used to repair the damaged tissue in the hip joint. This includes the so-called Microfracturingwhere bleeding occurs and that Tissue for cartilage formation stimulate. There is also the process of Cartilage transplant, in which cartilage is removed from other joints and inserted into the affected joint, or the procedure of Stem cell transplant, in which stem cells are stimulated to form cartilage tissue and the material is then inserted into the affected joint.
Surgery for cartilage damage to the hip
Treatment of Cartilage damage at the hip depends on the severity of the Hip arthrosis (Classification according to ICRS: International Cartilage Society).
- Is there a Stage 1 hip arthrosis, finds a minimally invasive hip arthroscopy (Arthroscopy of the hip), in which overgrown bones and free joint bodies are removed and torn cartilage and the partially impaired joint capsule are removed.
- With advanced Arthrosis stage 2 In younger patients under 60/65 years of age, joint-preserving surgery via arthroscopy hardly makes any sense. Come here Hip joint prostheses for use under general or partial anesthesia through a skin incision over the lateral hip joint (anterolateral approach) to be built in. In order to preserve as much of the healthy hip joint or thigh bone as possible, either only a femoral head cap without a femoral neck resection or an implantation of a short stem prosthesis is usually carried out in this case.
- For an advanced one Hip joint arthrosis stage 3 in older patients over 60/65 years, however, a complete hip replacement is usually sought, whereby both the femoral head and the acetabulum are replaced.
Cartilage Growing (ACT)
Cartilage cultivation is understood as the so-called cartilage cell transplantation (also synonymous with autologous chondrocyte transplantation (ACT)), in which cartilage can be rebuilt by introducing cartilage cells into the affected joint (e.g. hip joint).
This procedure is mostly performed on younger hip joint patients with deep but locally limited cartilage damage that is surrounded by still intact cartilage tissue.
As a rule, the body's own cartilage cells are used for cartilage transplantation, but donor cells can also be used in certain cases.
In the case of the body's own cartilage cultivation, the patient is taken from an intact area of cartilage as part of a joint reflection (Arthroscopy) healthy cartilage cells are taken by means of a biopsy, which can then be cultivated in the laboratory under certain conditions. In a further step, these cartilage cells are cultured or increased in the serum of the patient's own blood, which was also taken during the arthroscopy, for 3-4 weeks.
In the last step, the cultivated cells are reimplanted into the patient in a new, minimally invasive procedure on the hip joint after the defective cartilage tissue has been removed. The cartilage cells that have been introduced now grow into the defect and multiply, so that complete regeneration of the cartilage is expected after approx. 1 year.
Risk groups and prophylaxis
There are a few factors that contribute to this Promote the development of cartilage damage in the hip joint. This includes groups that affect the hip joint for professional, athletic or anatomical reasons extraordinary burden to expect. People are also at risk if they take part in activities in which external injuries to the hip joint cannot be ruled out.
Cartilage damage at the hip joint can be caused by a gentle treatment of the joint can be successfully avoided in many cases. This includes stressful movements to avoid in your free time as well as at workas well as your own body weight to reducethat the mechanical stress on the joint is reduced. It may also be necessary to be particularly stressful sports to refrain if cartilage damage in the hip joint is known and there is pain in this region.
In any case, it is advisable to use the to consult the attending physician and to explain the problem to them so that consequential damage from untreated cartilage damage can be avoided.
