Acıbadem Fulya Hospital Orthopedics and Traumatology Specialist Prof. Dr. İbrahim Tuncay talked about the 3 diseases that most often cause hip pain and gave important warnings.
Hip calcification
Stating that osteoarthrosis, known as 'hip calcification' among the people, is a disease characterized by the erosion of the cartilage forming the hip joint for various reasons and the deformation of the underlying bones, Prof. Dr. İbrahim Tuncay said, “Among the symptoms of hip arthritis, the most disturbing condition for the patient is the pain that develops around the groin and/or hip. The pain, which is initially only present when walking a certain distance, getting into a vehicle or climbing stairs, can develop over time even when resting, and can reach a level of intensity that wakes the person up during sleep. Due to the increasing limitation of movement in daily life, the patient may become unable to meet his needs such as climbing stairs, wearing shoes and socks.” said.
prof. Dr. İbrahim Tuncay stated that the treatment of hip arthritis consists of two main groups as conservative (non-surgical) and surgical, and said, “Conservative methods including medication and physical therapy aim to reduce pain and maintain range of motion and muscle strength until the surgical stage. Surgical treatments are also divided into groups such as hip arthroscopy, osteotomy and arthroplasty (hip replacement), which are bone reshaping methods.” he said.
Giving information about Hip Prosthesis, Prof. Dr. İbrahim Tuncay said, “In hip replacement surgery, which is applied in the treatment of hip calcification and expressed as the surgery of the century, successful results are achieved over 90 percent. Total hip replacement is the surgical method applied to replace the damaged joint with an artificial joint due to calcification of the hip joint. prof. Dr. İbrahim Tuncay stated that if the prosthesis surgeries are performed correctly, the prosthesis functions like a natural joint that does not cause any complaints in the patient for many years, and said, “Today, high quality and suitable prostheses can last for more than 20 years, even up to the 30s, in patients who have not developed any complications. At the end of an average of 6 weeks, which is the soft tissue healing process, most patients can return to their normal lives without support and almost no restrictions.
"Robotic surgery, which has been successfully applied in recent years, also makes a very important contribution to this process," said Prof. Dr. İbrahim Tuncay continued as follows:
“The most important feature of robotic surgery; It is designed in a computer environment before the surgery, allowing bone incisions to be made with minimal error and ideal placement of prostheses in the area. Thanks to these effects, early complications such as dislocation of the hip and vascular and nerve lesion, although rare, are minimized. In addition, thanks to the placement of the prosthesis in the ideal position, wear and loosening of the prosthesis occur later with homogeneous load distribution, so the prosthesis has a longer life. It is predicted that robotic prosthesis surgery, whose popularity has been increasing in recent years, is expected to reach the indispensable point in arthroplasty in the near future, where perfection is expected.
Osteonecrosis of the hip
Giving information about osteonecrosis in the hip, Prof. Dr. İbrahim Tuncay said, “Like all organs in our body, bone tissues are fed with blood. In cases where sufficient blood does not reach, the tissues and cells of the bone die, as a result of which collapses occur in the bone. The death of this tissue is called avascular necrosis or osteonecrosis. The loss of strength of the femoral head and its collapse over time is manifested by the 'pain' that occurs around the hip. The most prominent feature of the pain is that it increases with hip movements and spreads from the front of the leg to the knee. While the person has a limp problem due to collapse, calcifications that may develop in the future can cause serious restriction in joint movements. gave the information.
If the necessary intervention is performed before the collapse of the bones occurs, the success rate of the treatment increases. Orthopedics and Traumatology Specialist Prof. Dr. İbrahim Tuncay stated that the treatment was planned completely according to the current condition of the damaged area and said, “The main purpose of the treatment is to prevent collapse on the joint surface. When detected in the early period, the problem is usually resolved with drug treatments such as blood thinners, hyperbaric oxygen therapy and physical therapy support. If these methods do not yield results and if there are joint collapse or pre-existing findings in the radiological evaluations, surgical methods are applied.
prof. Dr. İbrahim Tuncay continued as follows:
“The operation called 'core decompression' is performed before the complete collapse. The aim of this operation is to reduce the pressure that prevents feeding on the head of the thigh bone, thus ensuring the blood supply to the head again. Cellular treatment applications such as PRP, bone marrow and stem cells can also be added to the operation. In patients who do not benefit from these treatments, operations called osteotomy and changing the load-bearing area of the bone can be performed. When collapse occurs, total hip replacement surgery is performed, which is the only option and has the highest patient satisfaction. In this picture, it is an important advantage to use robotic applications that both offer benefits such as the complete disappearance of pain with minimal risk of complications in the early period, and ensure a long life of the prosthesis to be used in this pathology, especially in young patients.”
Hip Impingement Syndrome (Femoroacetabular Impingement Syndrome)
prof. Dr. İbrahim Tuncay stated that hip compression is a disease that occurs as a result of the abnormal contact of the two parts that make up the hip joint during movement due to structural problems in the hip, and said, “Patients usually complain of C-shaped pain around the hip while wearing trousers, getting into the vehicle or sitting cross-legged. If this syndrome is not recognized in time and the necessary intervention is not made, it can cause irreversible damage to the joint, namely hip calcification. said.
“Although physiotherapy methods are used in the early stages of the syndrome, the treatment of hip impingement syndrome is surgical,” said Prof. Dr. İbrahim Tuncay concluded his words as follows:
With open or closed (arthroscopic) methods, both sides of the pathology (thigh head and hip socket) are reshaped and the labrum, that is, the triangular cartilage tissue in the structure of the hip joint, is repaired if it is torn and can be repaired. If it is beyond repair, it is removed or repaired with another tissue. Certain movements are restricted for 4-6 weeks after the surgery and it is recommended to use a pair of walking sticks. Then the patient can quickly return to normal life and sports. After a successful operation, the patient's early hip pain disappears or decreases, and in the long term, the process of calcification is delayed or completely prevented.