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Hip

Hip Overview

The traditional view of a hip surgeon has been that of a surgeon specialising in hip replacement surgery. However, with improved technology and techniques, there has been an emergence of a group of 'hip surgeons' who now offer arthroscopic (keyhole) surgery, conservative treatments guided by ultrasound control, as well as total hip replacement surgery in its various forms. As with all medical disorders, you should discuss your condition with your GP who will be able to offer initial advice.

Arthritis

The mention of hip arthritis instils a picture of a patient having to undergo hip replacement surgery. The concept of "being too young" still pervades and can prevent many patients from seeking treatment at an early stage in their disease. Current treatment options are aimed to allow you to maintain your lifestyle, with minimal disruption with time from work and physical activities.

Simple investigations such as X-rays will often give an indication as to the severity of hip disease, though the degree of arthritis seen on X-ray is not always related to the amount of pain no symptoms a patient might experience.

In early arthritic disease treatment options may be guided by investigations such as MR scanning or nuclear medicine bone scanning. For early arthritis options such as keyhole surgery, where the hip can be "tidied up" can be undertaken as day case surgery. In other cases patients may benefit greatly from injections into the hip joints of either steroids or Hyalgan preparations, which can offer good symptomatic relief of pain, again being performed as a day case.

In the more severe case of arthritis where simple treatments have failed, then joint replacement will always be an option, irrespective of age. In traditional hip replacement surgery the long-term results are excellent, with in the order of 95% of patients having a successful operation, i.e. being pain free without complications.

A number of patients do find themselves in a diagnostic dilemma, in that they may have back pain, causing pain in the hip region, as well as hip arthritis. Current investigations allow surgeons to ascertain with reasonable accuracy the source of the majority of the hip pain and allow treatment to be targeted to the correct area.

Injury and Pain

Hip injury and the management of hip pain have progressed to levels seen in the knee. Many injuries around the hip joint affect the soft tissues. Traditionally, clinical findings are confirmed by MR scanning, though modern techniques of ultrasound offer a greater resolution and diagnostic accuracy. In many disorders, i.e. tendon sprain, muscle tears and many treatments can now be performed under ultrasound control, where as in the past injections were often performed on a "semi-blind" basis.

State of the art investigations including 3-tesla MRI scans, MR arthrography (injecting a 'dye' into the joint) gives even greater clarification of the nature of hips disorders, allowing extremely accurate diagnosis of damage to the joint surface or injuries such as labral tears (similar to a cartilage tear of the knee).

In the last 15-20 years a small group of surgeons have emerged who offer hip arthroscopy (keyhole surgery) as part of the investigation and treatment of hip pain. Keyhole surgery, performed as a day case, allows many active patients to benefit from this treatment following sporting injuries.

Contact

As with all medical conditions you should discuss this with your GP who will be able to offer initial advice.

For further information please contact our Practice Manager on 0161 728 5994, 0161 793 7056 or use our on-line enquiry form. Alternatively, you may book an appointment with Mr Maxwell at the Oaklands Hospital.