The hip is a strong and stable joint, as it is supported and protected on all sides by the muscles of the buttocks, lower back and thighs. However, just like other joints, it is prone to overuse injuries. This is especially true for athletes and active individuals.
Injuries resulting in direct impact to the hips are also a possibility, particularly among athletes in contact sports.
Some conditions and injuries may necessitate more than just rest, pain medication or therapy to treat and, instead, require hip replacement surgery.
Hip replacement is an increasingly common treatment for certain conditions affecting the hip joint. Below, we discuss some reasons athletes may need this surgical procedure and provide an overview of the available treatment options.
Reasons Why Athletes May Need Hip Replacement
Contrary to common misconceptions, hip replacement is not just for older adults. It is also a viable treatment option for athletes of any age who have certain hip-related conditions, such as the following:
A hip impingement, also referred to as femoroacetabular impingement (FAI), occurs when the femoral head, the ball of the hip, and the acetabulum, or the socket into which the femoral head fits, don't fit correctly.
This causes the femoral head and the acetabulum to rub together, causing hip pain that worsens during exercise or when sitting for long periods. Hip impingement can also result in the following symptoms:
- Stiffness in the hip
- Difficulty going up the stairs
- Loss of balance
- Inability to flex the hip beyond a right angle
However, some people with hip impingement may not notice any symptoms until the damage in the hip has worsened.
Hip impingement causes abnormal friction on the hip joint and excessive wear and tear. If left untreated, hip impingement may result in osteoarthritis and require surgical replacement of the hip.
Hip impingement can affect athletes of any biological sex, but it is more common among men. Also, hip impingement in men can lead to another hip condition called hip labral tears.
Activities such as ice hockey, soccer, basketball and football, which involve frequent pivoting, sudden direction changes and movement of the legs beyond the normal range of motion, can increase the risk of hip impingement. Additionally, sports like long-distance running and cycling, which involve repetitive hip flexion, can contribute to this condition.
Stress fractures often occur in the upper neck of the femur or thigh bone. Unlike high-energy fractures caused by falls or fractures caused by tumors, infections or osteoporosis, stress fractures are caused by repetitive stress and overuse.
In stress fractures, the hip bone weakens over time until a tiny crack forms. The main symptom of stress fractures is pain in the hip or groin area that worsens with activity and eases with rest,
Stress fractures are often seen in athletes who perform in high-impact sports, such as long-distance runners who repeatedly place stress on the hip. Stress fractures are also prevalent in athletes who have nutritional deficiencies.
Early intervention for stress fractures in the hip can be particularly challenging to achieve because they often go unnoticed until they progress to a more severe stage. They can be so small that they cannot be seen on a regular X-ray. Instead, doctors may order MRIs or bone scans to diagnose a stress fracture.
However, stress fractures must be treated as soon as possible. If the bone is left to weaken, the fracture can cause the hip bones to move out of alignment. This could lead to blood supply to the area being cut off and result in bone death.
Avascular Necrosis of the Femoral Head
Also known as osteonecrosis, this condition occurs when the blood supply to the femoral head is disrupted, leading to the death of bone tissue. In turn, this can cause the femoral head to collapse, resulting in severe hip pain and joint dysfunction.
Athletes who engage in high-impact activities are at a higher risk of developing avascular necrosis because of the repetitive stress they place on their hip joints. Early detection and intervention are essential to preserve hip function in athletes with avascular necrosis, as it can progress to the point of requiring hip replacement surgery if left untreated.
Hip Replacement: When Does It Become Necessary?
For most conditions affecting the hip, the first line of treatment is rarely surgery. Instead, approaches involving pain medication, nonsteroidal anti-inflammatory drugs (NSAIDs), joint injections and physical therapy are typically recommended.
Hip replacement surgery becomes necessary when more conservative treatments no longer provide relief and when an individual's hip joint is significantly damaged or compromised, leading to chronic pain, reduced mobility and a diminished quality of life.
The decision to undergo surgery is generally made in consultation with orthopedic specialists who consider the patient's overall health, activity level and the extent of hip damage. While the choice to undergo surgical replacement of the hip can be difficult, it allows athletes to live a pain-free and active lifestyle once again.
Exploring Hip Replacement Options for Athletes
There are different types of hip replacement surgeries, and the choice of the best hip replacement for athletes depends on various factors.
- Total hip replacement: This involves replacing worn-out or damaged parts of the hip with implants made from plastic, ceramic or metal materials.
- Partial hip replacement: This involves replacing only half of the hip joint, specifically the femoral head, on one side.
- Hip resurfacing: This is another treatment option wherein the damaged surface of the femoral head and the socket is trimmed. The femoral head is covered in a metal cap, while a metal shell is placed in the socket. The hip resurfacing procedure results in smooth, painless motion.
Which option is the best for the athlete ultimately depends on their hip condition, age and activity level. A consultation with a trusted orthopedic surgeon is a must to determine the most suitable hip replacement approach.
Personalized Hip Treatment Plans for Athletes
Dr. Benjamin Domb is a nationally recognized orthopedic surgeon specializing in Sports Medicine and Hip Arthroscopy. He has treated many professional, Olympic and elite-level athletes and is considered to be among the most experienced hip arthroscopy surgeons in the world.
Dr. Domb treats patients at his three practice locations in Illinois. To request an appointment, call (833) 872-4477 or send a message through the online form.