Hip pain and hip surgery

Joint replacement was previously reserved for elderly patients because we know that over 80% of implants will survive 20 years, but much less will survive in the more active and demanding younger patients. There is no doubt that joint replacement can make an enormous positive difference in the quality of life in younger patients, and should not be denied to them. Advances in technology such as high performance hip replacement bearings and implants have improved implant survival in this group. However, the likelihood of further re-do surgery is inevitable, and this presents potential future problems for these patients. Options more suited to the younger hip patient are joint preserving procedures such as osteotomies around the hip, impingement surgery, alternative bearings and resurfacing of the hip.

Hip resurfacing is a specialised kind of hip replacement where the minimal amount of bone is removed from the head of the femur. See, Hip resurfacing Advantages of this implant are preservation of bone and anatomy, a hardwearing bearing, hip stability, and potential for very high levels of patient activity. It is the only hip that potentially allows the patient to return to any activity including running, climbing etc. Resurfacing is best suited to high activity, young, male patients without significant bony deformity. It has become apparent that the cause of hip arthritis in the majority of these young athletic males is femoro-acetabular impingement, and resurfacing is ideally suited to deal with the pattern of arthritis that this causes.

Our routine hip replacement patients will usually be able to go home on the second to third day post operatively (although individual requirements vary). See, Minimally invasive hip replacement

It used to be thought that arthritis of the hip was nearly always caused by just wear and tear (primary Osteoarthritis). More recently, it has become apparent that actually in the vast majority of cases a structural abnormality can be identified that has caused the arthritis to develop (secondary Osteoarthritis). The majority of these abnormalities occur before birth, or in childhood and include, developmental dysplasia of the hip, femoro-acetabular impingement, slipped upper femoral epiphysis (link) and Perthes disease. Other causes of secondary arthritis include conditions that cause damage to the cartilage including; trauma, avascular necrosis, infection, and inflammatory arthritis. Even within those cases, where no obvious cause is found for the Osteoarthritis (primary Osteoarthritis), there is often a strong family history of hip disease, suggesting a genetic weakness in the patient’s cartilage. See, Total hip replacement

The decision to undergo total hip replacement always remains with you, the patient. The surgeon will make sure of the diagnosis and advises you of the implications and possible complications. Pain and loss of function are the most important indications for joint replacement surgery. See, Total Hip Replacement