Hip Review Clinic
Hip Revision Surgery
Deciding to have an operation, especially an irreversible joint replacement, requires personal reflection about how intrusively the symptoms are affecting your enjoyment of life. You need to be honest with yourself; choosing to have an operation because you don't want to admit to getting older is a recipe for unhappiness!
Causes of pain round the hipThere a large number of causes of hip pain. These range from irritation of the adjacent muscle and tendons, pre-arthritic problems with the joint, collapse of the bones and various types of arthritis causing destruction of the normal hip joint. Diagnosis of hip pain is not usually difficult - as long as the hip joint is examined thoroughly. It is important to distinguish between true hip pain and pain arising from the spine or sacroiliac joints as these conditions are treated by different specialists.
Diagnosis of hip problemsAccurate diagnosis is paramount and there have been significant improvements in the investigations available to pin point the problem (e.g. Digital x-rays, MRI, CT, Bone Scan, Arthrography).
Throughout my practice, and while teaching, I always recommend an analytical approach; use investigations and treatments only when necessary and only for the patients best interests. Many conditions can be confidently diagnosed after a consultation, examination and simple x-rays. In these cases the added costs of further tests brings no benefit. Conversely some patients have rare presentations or unusual problems that are only evident after a campaign of tests.
Treatment of hip problemsIn my practice patients make the decisions about their care, my role is to provide information about the risks and benefits. I work with specialist physiotherapists to offer effective treatment when surgery is not appropriate. Soft tissue problems around the hip will usually respond to a combination of physiotherapy and occasional joint injections.
There is growing interest in joint preserving operations to relieve symptoms due to wear and tear. It is not clear if these interventions will prevent or retard the development of arthritis.
For hip joints that are very damaged and causing significant disability some form of total hip replacement is the mainstay of treatment.
Care for patients with hip replacementsRegular follow up must include an assessment of symptoms and appropriate x-rays. Usually this follow up is arranged by your surgeon, often in a dedicated hip review clinic. It is my practice to recommend follow up a year after surgery and then every five years.
A small number of patients will experience problems after a total hip replacement. These problems can be serious enough for the joint replacement to be changed for a new one - revised. Revision hip surgery requires careful planning and a wide range of equipment and expertise.
I'm happy to offer a follow up appointment for your hip replacement, or a second opinion regarding problems with a hip replacement, even if the operation was undertaken some years ago or in another hospital. It is always helpful to know the brand and type of your hip replacement if possible.