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Hip Surgery
The hip is a large ball and socket joint. It is essential to normal daily activity with problems from hip joint pathology affecting patients’ ability to walk, sit, work and play.
Our hip specialists at The Orthopaedic Group deal with hip problems across all ages and can help you manage your symptoms, with advice on non-operative treatments as well as the full range of surgical interventions backed by evidence and supported by current technologies.
Our team can manage hip problems from dysplasia in a newborn through sporting injuries in children and younger adults, to degenerative problems in older adult life.
Conditions
Hip Arthritis
Hip Arthritis
Arthritis describes a loss of cartilage from a joint resulting in pain, stiffness and a loss of function. Commonly it is described as “osteoarthritis” when attributed to wear and tear, but can be caused by inflammatory conditions such as rheumatoid arthritis, or following injury, infection or childhood hip problems. Patients typically describe an aching type of groin pain aggravated by activity and often worse in the evening.
Hip Dysplasia / Hip impingement (FAI)
Hip Dysplasia / Hip impingement (FAI)
Dysplasia describes an abnormality in the shape of hip joint, but most commonly refers to a “shallow” socket. It causes uneven pressure on the socket and typically presents with activity related groin pain in younger adults.
Patients with very deep sockets or abnormally shaped femoral necks may also present with pain. This is typically aggravated by squatting or bending and is termed “femoral-acetabular impingement”.
Labral Tear
Labral Tear
The labrum is a tough fibrocartilage that runs around the edge of the hip socket. It helps make the socket deeper and provides a suction seal to the hip. It is occasionally damaged by trauma or where there is an abnormal socket shape (dysplasia) and may need repair or correction of the underlying cause.
Many labral tears seen on MRI scans however do not cause symptoms and do not require treatmet
Gluteal Tendon Tear
Gluteal Tendon Tear
The gluteal tendons attach the pelvis bone to the thigh bone. They are important in helping to keep a level pelvis when walking or standing. Tears in the tendons can occur from trauma or degeneration with age and often cause pain around the outside (lateral) hip. Symptoms are typically aggravated by activity or when lying on the affected side.
Swelling adjacent to the tear is called “trochanteric bursitis”.
Childhood Hip Problems
Childhood Hip Problems
In pregnancy and during growth several conditions may change the shape of the hip and impair normal hip function. Conditions include Developmental Dysplasia of the Hip (DDH), Perthes Disease and Slipped Capital Femoral Epiphyses (SCFE). These may cause pain, restrict movement or cause a limp. Treatments such as bracing in infancy or surgery in older children and adults can often improve the mechanics of the hip joint and allow improved function. These surgeries are varied and tailored to the specific functional problems of each patient.
Procedures
- Total hip replacement
Hip replacement surgery is one of the most successful surgeries across all surgical specialties. It removes the damaged joint and replaces it with an artificial bearing that relieves pain and preserves movement. The goal of the surgery is to keep patients active and improve the quality of life. It is typically the treatment of choice for hip arthritis.
- Revision hip replacement
Although highly successful at relieving pain, total hip replacements can wear out over time or be damaged by infection or injury. This may require some or all of the parts of the joint to be replaced again, termed “revision” hip replacement. This is a more complicated procedure and is performed by a smaller number of surgeons.
- Hip arthroscopy
Arthroscopy describes the use of a camera and specialist tools to work inside a joint. This is done through small “key-hole” incisions in the skin and in the hip. Arthroscopy can be used to treat injuries to the hip labrum, to reshape the edge of the socket, or to remove a “bump” or “CAM lesion” from the femoral neck to relieve hip impingement.
- Hip osteotomy. (Peri-Acetabular Osteotomy / Femoral osteotomy)
Osteotomy describes cutting of a bone. Around the hip this is commonly performed to improve the position of the hip socket in impingement or hip dysplasia. Cutting around the socket is called a “peri-acetabular osteotomy”. Osteotomies may also be performed in the thigh bone (femur) to improve the function of the hip, change the position of the leg, or treat problems following injury, congenital differences, or childhood hip problems.
- Gluteal Tendon Repair
Trochanteric bursitis and gluteal tendinopathy can typically be treated with non-operative techniques, but in patients where symptoms persist surgery is sometimes required. This surgery removes the unhealthy parts of the tendon, bursa and bone and reattaches the remaining tendon to the hip bone (trochanter). The addition of an artificial “LARS ligament” is often made to support the tissue and increase the speed of rehabilitation and strength of the repair. Following surgery an extensive rehabilitation program is required to rebuild strength in the gluteal muscles.
Operating Technology
The Orthopaedic group uses the most up to date technologies in surgical care.
The Orthopaedic group uses the most up to date technologies in surgical care. This includes the use of custom computer planning and modelling in arthroplasty and osteotomy, as well as robotic assisted joint replacement. These tools give your surgeon a range of options that assist in delivering the surgical plan correctly for each individual.
