I am in my mid 40s and have this aching hip pain that radiates to my knee. Someone told me that I might have femoral osteonecrosis. How is this detected? How do they determine how bad it is? An MRI is the gold standard for femoral osteonecrosis detection. Surgeons determine the stage of the disease progression by location, size, and amount of swelling present.Reference: Charalampos G. Zalavras, M.D. and Jay R. Lieberman, M.D. Osteonecrosis of the Femoral Head: Evaluation and Treatment. The Jo...

My mom was recently diagnosed with osteonecrosis of her hip and I’ve been told that it’s hereditary. Do I need to be worried about this? Although the underlying pathology is not quite understood there are multiple factors that must occur to develop femoral osteonecrosis. The primary risk factors are excessive corticosteroid or alcohol use, trauma, or a blood clotting disorder. The blood clotting disorder can be hereditary, but does not necessarily mean that you will develop the ...

Many articles have been written about the condition affecting the hip known as femoroacetabular impingement (FAI). But the current definition is not specific enough to be used when planning clinical trials.Therefore, the orthopedic surgeons at The Children's Hospital of Philadelphia (CHOP) have taken on the task of defining this condition with clinical trials in mind. Secondly, they reviewed what is known about the relationship between femoroacetabular impingement (FAI), the later development of...

I've been monkeying around with a hip problem for months now. I've seen the doctor four or five times. Each time, there's a different test ordered. First, there was an examination with poking and prodding. Then it was X-rays, and then an MRI. So far, they think I may have something called FAI. Now they want to inject a numbing agent (like Novacaine) into the hip to see if the pain is really coming from the hip joint. Why is something like this so difficult to figure out? Femoroacetabular impinge...

I am at a crossroads in my life. I have a hip problem called FAI and trying to make good decisions about treatment. I am actively involved in college sports and I don't want to give that up. But my surgeon tells me if I keep reinjuring myself and repetitively pinching the hip with activities, I could end up with early arthritis. She has suggested I try physiotherapy first if I don't want to be on the bench for the season while recovering from surgery. Maybe I should just take the plunge and have...

You will probably recognize me because I have visited your website before and asked several questions. You have always been helpful, so I hope you won't mind one more question. How do I compare having a hip replacement with the new mini-incision versus the standard open incision? The surgeon I am seeing offers both. I get to make the final decision. Your question comes at a good time with the recent publication of a study conducted at the Health Services Research Unit at the University of Aberde...

An update on the treatment of post-operative infection following hip replacement was recently published that may have some useful information. There are some new developments and advances in this area. One question being investigated is: since there are so many different ways to approach the problem: which treatment gives the best results?Treatment for this problem is usually surgery including one (or more) of the following procedures: 1) irrigation and debridement, 2) one-stage exchange, 3) two...

As a teen, I had a hip condition called FAI. My parents took me to a surgeon who operated but I still have chronic pain and stiffness every day of my life. I don't remember what the surgeon did to help me back then but I'm wondering if there's some other procedure I could have now that might work better. What can you tell me? Femoroacetabular impingement (FAI) occurs in the hip joint. Impingement refers to some portion of the soft tissue around the hip socket getting pinched or compressed. Femor...

I am a 72-year old avid tennis player and golfer but the pain in my right hip is really affecting my score in both games. I saw a surgeon who suggested trying a modified hip replacement using what he called a short-stem implant. But he didn't answer my question whether or not this type of hip replacement would get me back into action. What can you tell me? Of course there's no guarantee after any surgery that everything will go exceedingly well. Surgeons are usually conservative in their recomme...

Can I train for a half-marathon after having a hip replacement? I should qualify that by saying the type of hip implant they are recommending is a short-stem. This is supposed to make it possible for me to be more active -- but how active is that, exactly? More than ever before, adults are seeking and receiving hip replacements at a younger age and with the intent of remaining active in recreational and sports activities. The results of a recent study from the University of Munich in Germany ma...

I'm 16, play football defensive end, and have a torn meniscus. How long will it take to get back on the football field?

Help, please! Dad is in the hospital for a hip fracture. They've pinned it and started him on physiotherapy. The doctor and therapist insist he has to get up and walk on that leg. Dad says he needs a couple of days to rest and recouperate before getting up. What can we tell him to convince him to go along with this approach? Immediate weight-bearing after surgery for hip fracture has been proven safe and effective in several studies. But as a general protocol, the medical practice of getting peo...

My father-in-law, mother-in-law, and my own mother have all fallen and broken their hips. Of course, we never really knew if the hip broke and they fell or they fell and the hip broke. In any case, I got to wondering why is it always the hip that breaks? Why don't older adults who fall break a leg or an ankle instead? It's a good question and one that may not have a single best answer. First, it should be noted that osteoporosis (brittle bones from loss of bone density) is a common problem in th...