Treatment of hip conditions

The importance of prompt and accurate diagnosis of chronic hip pain cannot be over-emphasised.

Some conditions, for example mild osteoarthritis, can often be treated by specialised injections or minimally invasive treatments such as hip arthroscopy.

This can delay, often for several years, the need for more serious operations such as a partial or complete hip replacement.

Hip Conditions

Step 1: Diagnostic services for hip pain

Modern technology is extensively employed to enable accurate diagnostic techniques, which can usually establish the cause of chronic hip pain, enabling prompt and relevant treatment. These include:

  • X-ray
  • Ultrasound
  • CT scans
  • MRI scans

An initial discussion

If you suffer from chronic hip pain, you may want to arrange a preliminary consultation either at your direct request, or through referral by your GP or another specialist.

During this discussion, we will make an initial examination, and recommend suitable tests to obtain more detailed information. This will enable us to make detailed proposals for your further treatments, and to explain all of the relevant procedures.

For any patient presenting to our clinic with a suspected joint replacement infection we offer the latest technology with Synovasure® Alpha Defensin Test, to aid the diagnosis and allow us to discuss the most appropriate treatment options with our patients.

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Step 2: Non-operative therapies for hip pain

Depending on the results of the diagnosis, chronic hip pain can be eased or eliminated using non-surgical techniques, which include the following:

Targeted physiotherapy by a qualified and experienced practitioner has been proved very effective for treatment of hip pain caused by bruising, strains or muscular-inflammation.

Orthotics is a specialist process, which involves the design, manufacture and fitting of orthoses, which will support or restrict joints following injury or trauma.

They are usually purpose-designed and made, and are often used after a fracture or in the case of ligament/cartilage tears. They help to prevent strain and further injury, and thus help recovery.

Hip braces – often padded or elasticated – are also used for this purpose.

The cartilage that coats the bones in the hip ensures that it moves smoothly. It is lubricated by the synovial fluid, which is produced by the coating of the capsule, which holds the bones in place.

If the cartilage is damaged or becomes worn, and synovial fluid is not produced, the result can be bone-on-bone movement, which is painful and causes inflammation in the joint.

The solution to this can be an injection, of which the two most commonly used are:

  • Depo-medrol is an anti-inflammatory steroid, which is injected, often with a long-lasting local anaesthetic, to reduce chronic pain or swelling caused by inflammation.
  • Durolane, contains synthetic stabilised hyaluronic acid, which is similar to the lubrication naturally produced in the joint.

Injections are carried out either in the surgery, or as an outpatient, and do not involve hospitalisation.

Step 3: Operative hip treatments

The function of the hip means that the treatment of trauma, chronic inflammation, degeneration and severe osteoarthritis will often involve major surgery.

Since the first full hip replacement operation in 1960 (at the Wrightington Hospital in the UK), many thousands have been conducted worldwide.

Full hip replacement involves replacing the femoral “ball” at the top of the thigh-bone with a metal implant topped with a ball that is often coated with an alloy or ceramic material.

In the pelvis, the socket is usually hollowed-out and a replacement socket made of high-density polythene, ceramic or alloy is inserted.

Some prosthetic hips are fixed in position using acrylic cement; other prosthetics has a textured surface over which the bone grows.

At the time of your consultation with us, the full range of options in hip replacement bearing surfaces will be discussed.

The technology and techniques for hip replacement are now well-established, and in the majority of cases new hips using the CPT/Trilogy and Exeter components last 15-20 or more years.

However, artificial joints such as hips sometimes require replacement, using a procedure called revision surgery.

Hip revisions are usually straightforward, although they do involve more complex techniques.

In our team, we handle an increasing number of revisions, using specialist implants, and the majority of patients are able to regain full and pain-free mobility.

While most hip replacements can give years of improved mobility to patients, in a minority of cases infections occur, often after several years of use. The treatment of these cases is more complex than standard revision surgery, because it is important to identify and control the infection at source. Depending on their type and source, we treat these infections using some or all of the following:

  • debridement, where the infected area is cleaned out under surgery
  • modular exchange, where one or more component of the artificial hip is replaced
  • implant retention, where the femoral implant and/or acetabular module is re-fixed as needed
  • antibiotic treatment, to prevent a recurrence of the infection

Personal outcomes following hip surgery

Each year, hip replacement therapy enables thousands of patients to enjoy an active life, free of chronic hip pain.

Once all of your diagnostic procedures are complete, your options will be explained to you in detail, including an explanation if surgery is recommended and details covering the operation itself.

Fortunately, risks these days are small, but it is important for you to understand them.

Likely outcomes will also be discussed, including the recovery process and future prospects for your personal situation.

Take the first step to a pain-free life

If you are experiencing pain in your pelvis, hip, knee or ankle, or are suffering from a sports injury, seek specialist help to get you back to living your life.

Telephone:
+44 (0)1223 667376

Email:
enquiries@carrothersnorrish.co.uk

Contact can also be made through your GP.