Hip Preservation Surgery for early hip arthritis or sports injuries
‘Hip Preservation Surgery’ is a non specific term referring to surgical methods aimed at preserving the native (patient’s own) hip. This is of course highly preferable to say, proceeding with a hip replacement at a young age, say 40-50 years old. My interest in this area stems from my research and training in managing patients with early hip osteoarthritis.
When a young patient (< 60 years old) presents with symptoms and signs of hip arthritis, e.g. groin pain, aching discomfort which is often activity related, an awareness of pain which affects day to day or leisure activities, it is important to understand the underlying factors contributing to the development of the hip arthritis. Standard x-rays would identify a developmental problems such as a ‘shallow’ socket or previous infection. Often, patients have signs of arthritis without apparent predisposing factors.
HIP IMPINGEMENT/ FEMOROACETABULAR IMPINGEMENT
Our understanding now is that subtle anatomical factors (excess bone around the rim of the hip socket or hip region or both) can predispose an individual to hip osteoarthritis, by causing repetitive abutment or hip impingement, leading to early hip arthritis. This is a developmental condition, meaning that it is probably a condition that developed as the shape and size of the hip bone grew and matured. There is increasing evidence that the shape and alignment of hip joints can predispose individuals to the development of early hip arthritis.
My role is to identify these factors, with the ultimate aim of preventing (if possible) progression of a patient’s hip osteoarthritic changes. This remains un-proven, but a big part of my practice revolves around collecting relevant clinical data, staying up to date with advances in research and contributing as much as I can to the research and clinical data.
Key hole surgery of the hip (Hip arthroscopy) is a special interest of mine. What we know now is that hip arthroscopy and techniques to re-shape and deal with associated underlying pathology in the hip, such as repair of a torn labrum (soft cartilage of the hip) can improve hip symptoms if patients are carefully prepared and appropriately selected for surgery. Key hole procedures of the hip are technically challenging procedures. It is important that your surgeon has appropriate training, interest and sufficient operative volume to ensure that you obtain a good result from surgery, if surgery is indicated
There is increasing evidence that subtle anatomical abnormalities around the hip can predispose certain individuals to the development of early hip osteoarthritis. The shape of the hip joint, alignment and development of the hip can predispose patients to a clinical entity known as “hip impingement.” This condition has been shown to be a precursor to early hip osteoarthritis.
MBChB, MSc, FRCSGlasg (Tr & Orth)
Consultant Orthopaedic Surgeon
Specialist in Hip and Knee Surgery
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