{"id":10419,"date":"2024-05-07T08:07:54","date_gmt":"2024-05-07T08:07:54","guid":{"rendered":"https:\/\/paleyinstitute.org\/?page_id=10419"},"modified":"2025-06-17T18:35:23","modified_gmt":"2025-06-17T18:35:23","slug":"hip-preservation","status":"publish","type":"page","link":"https:\/\/paleyinstitute.org\/hip-preservation\/","title":{"rendered":"Hip Preservation"},"content":{"rendered":"\t\t
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Hip Preservation<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Paley Institute Joint Preservation & Replacement Center<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Drs. Paley<\/a>, Feldman<\/a>, Barnhill<\/a>, Beleckas<\/a>, McVicker<\/a>, Quinnan<\/a>, and Lamm<\/a> have extensive experience in treating a wide range of hip problems, with excellent results. At the Paley Institute, we offer the most technologically advanced treatment methods, emphasizing joint reconstruction and preservation over joint replacement. Our expert team provides specialized hip preservation care at our West Palm Beach<\/a>, Jupiter<\/a>, and Boca<\/a> locations.<\/p>

Deformity of the hip joint may be due to femoral deformity and acetabular dysplasia. The acetabulum is the socket-shaped surface of the pelvis where the femoral head sits. Femoral deformity and acetabular dysplasia are often associated with each other. Femoral deformity can be secondary to acetabular dysplasia and vice versa. Deformity of the femur will often cause a resultant deformity in the acetabulum, and a deformity of the acetabulum will cause a resultant deformity in the femur. Furthermore, the shape of the upper femur is affected by any imbalance of muscle forces around it.<\/p>

For more information, see\u00a0Hip Dysplasia<\/a><\/span><\/p>

Deformities of the hip can be divided into coxa valga and coxa vara. Coxa valga is a deformity due to an increase in the angle between the head and neck of the femur and its shaft (normally 135 degrees). Coxa vara is the opposite: a decreased angle between the head and neck of the femur and its shaft. Coxa vara is usually indicated when the angle is less than 120 degrees.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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\n\t\t\t\t\t\t\t\t\tExample of normal proximal femoral angles. The MPFA is 85\u00b0 the NSA is 130\u00b0\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t
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\n\t\t\t\t\t\t\t\t\tCoxa Valga – NSA angle is >130\u00b0\n
\nCoxa Vara – NSA angle is <130\u00b0\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Anteversion of the femur (inward twisting) can create coxa valga. Coxa valga leads to acetabular dysplasia. Furthermore, the location of the greater trochanter on an anteverted femur promotes hip dysplasia. Acetabular dysplasia and femoral anteversion are usually associated with one another.<\/p>

Coxa vara, on the other hand, produces more amenable forces on the acetabulum. Therefore, when coxa vara is seen with hip dysplasia, it is not the cause of the dysplasia. Instead, both deformities are caused by the same disease process. One example of coxa vara with hip dysplasia is in Congenital Femoral Deficiency<\/p>

Femoral deformities can also arise after treatment of hip dysplasia. For example, treatment for avascular necrosis can result in growth arrest of the upper femur. This results in further deformity, such as coxa breva (shortening of the neck of the femur) and collapse of the femoral head, resulting in an elliptical or saddle shape.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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Hip Evaluation<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Evaluation of the hip is important for developing treatment strategies. The evaluation will include hip range of motion (ROM), assessment of hip impingement, rotation profile of the femur and tibia, hip flexion and abduction strength, and pain.<\/p>

X-rays provide most of the information needed for diagnosis. Computerized tomography (CT) may be useful to evaluate the shape of the femoral head and acetabulum. Magnetic resonance imaging (MRI) can be used to illustrate the soft tissues and assess impingement.<\/p>

Using the x-rays, the joint orientation angles of the hip are measured. These include:<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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