Hip Pain
The Symptoms
The symptoms of osteo-arthritis (OA) in the hip usually manifests itself with pain in the groin, sometimes even radiating to the knee which is referred pain. Many patients think that they have osteo-arthritis of the knee but in fact it is OA of the hip with referred pain in the knee. Osteo-arthritis of any joint is a condition that is sometimes called ‘wear and tear’.
When the pain is only mild and intermittent I would suggest a change in lifestyle. Losing weight, gentle physical activity (cycling, swimming, etc.) would be helpful. If your pain is not relieved by lifestyle change you may have to take medication. Anti inflammatory medication is usually prescribed. If the pain is not relieved by medication and change in lifestyle then I would discuss a total hip replacement with you.
Treatment:
Hip Injection or Arthroscopy
Hip Injection or Arthroscopy (in a very selected group of patients) If indicated I would discuss this at the time of your consultation.
Treatment:
Total Hip replacement
After discussion and examination we can agree a date for your operation. You will come in a few weeks before your operation for pre-operative checks and to discuss the anaesthetic. You can discuss the options with the anaesthetist of either having a general anaesthetic together with a local anaesthetic block (femoral and lateral cutaneous nerve of thigh) or a spinal anaesthetic. In both cases you will be comfortable during and after the operation. I use what is called the ‘lateral approach’ to the hip. The wound is kept as small as possible and when the hip is implanted well early recovery can be faster.
Choice 1:
Cemented total hip replacement
The cup and the shaft of a ‘cemented total hip’ prosthesis are fixed to the skeleton with a self curing polymer compound called bone cement. The bone cement fills completely the space between the skeleton and the surface of the prosthesis.
Choice 2:
Uncemented total hip replacement
For most of my patients I choose an ‘uncemented hip replacement’. A combination of the bearing surfaces are usually ceramic or high density polyethylene, Ceramic on Ceramic and/or Metal on high density polyethylene (HDPE).
The wear in a hip replacement is related to a number of factors. The young, active patient tends to wear out a standard hip replacement in 10 to 15 years. That is why we are constantly looking to develop better implants, better bearing surfaces and better ways of fixing implants. There are several different ways to reduce the wear and increase the implant life.
After the hip replacement you will wake up in recovery where you will be closely monitored until you are safe to return to the ward. Six hours after the operation you will be given an injection to reduce the risk of developing DVT (blood clot). The next day you may be sitting in a chair and able to walk under careful supervision of physiotherapists. Most of my patients return home between 3 – 4 days.
Follow up appointment in 2 and 6 weeks back at the hospital.