We treat a variety ofhip conditions at the Reading Hip & Knee Unit.
Click on the problem or injury that applies to you to find out more:
This is a common condition affecting nearly 2.5 million people in the UK. Hip arthritis occurs when the smooth surfaces of this ball and socket joint are worn away, leading to exposed bony surfaces which rub against each other when the joint moves. This can cause pain and stiffness of the joint. The pain can be sharp or dull and it is often experienced in the groin, thigh and buttocks. Some patients experience ‘referred pain’ in the knee. The pain can limit activities like walking and disturb sleep. The stiffness can lead to difficulties with getting dressed.
Hip arthrit is can occur due to:
1. Hereditary (genetic) factors i.e. passed down in families
2. Childhood conditions such as hip dysplasia , Perthe’s disease
3. Inflammatory conditions such as Rheumatoid arthritis
4. Trauma- hip fractures and dislocation
5. Life style problems-
Hip arthritis is usually diagnosed by examination and X-rays of the pelvis.
The early stages of hip arthritis can usually be well managed with non-operative treatments- for example , pain control medication , weight loss , the use of a stick and injections. When these treatments are no longer effective a hip replacement may be necessary.
If your hip is affected by arthritis, common every day activities such as walking or standing up from sitting may be painful and difficult. Your hip may be stiff, and it may be hard to put on your shoes and socks. You may even feel uncomfortable while resting and regularly have your sleep disturbed.
If painkillers, changes in your everyday activities, or the use of a walking stick do not adequately help to control your arthritic hip symptoms, you may wish to consider hip replacement surgery. First performed in the 1960’s, total hip replacement is now one of the world’s most successful operations, with over 80000 procedures performed in the UK every year. Total hip replacement is an operation that can successfully relieve your pain, improve your mobility, and help you return to enjoying normal everyday activities.
The hip joint is a large ball and socket joint. The socket is formed by the acetabulum, a part of the pelvis, and the ball is formed by the head of the femur, the top of the thighbone.
Total hip replacement is an operation to replace the arthritic ball and socket with a new smooth running and pain-free joint. To do this:
The arthritic femoral head is removed and replaced with a metal stem that is placed into the canal inside the femur.
The femoral stem may be held in place by cement, known as a cemented stem or by achieving a press -fit that jams in the femoral canal known as an uncemented stem.
A new ball made of metal or ceramic is placed onto the top of the stem replacing the worn out femoral head
The arthritic cartilage of the socket is removed and replaced by a new socket. This can be made of polyethylene that is cemented into the acetabulum.
Alternatively a metal socket that gains a press-fit in the acetabulum and has either a polyethylene or ceramic bearing surface can be used.
When a combination of an uncemented socket and a cemented stem is used this is a referred to as a hybrid hip replacement.
The surgeons in the Reading Hip & Knee Unit often use a hybrid hip replacement with a cemented Exeter Stem (Stryker) in the femur and an uncemented Trident socket (Stryker) in the acetabulum.
The Exeter/ Trident hybrid hip replacement has excellent long-term results in all age groups of patients with 97.7% survivorship at 10 years in the UK National Joint Registry. Find out more by clicking here.
The success of hip replacement is seen in the fact that over 97% of patients report a significant improvement in their hip pain and function after surgery in Nationally recorded Patient Reported Outcome measures (PROMS). Find out more by clicking here.
X-ray showing Osteoarthritis of the Right Hip Joint
X-ray showing a Right Hybrid Total Hip Replacement
Greater Trochanteric Pain Syndrome (Trochanteric Bursitis)
This is a condition which causes pain on the lateral aspect of the hip joint. The pain can be quite severe and interfere with activities such as running. The pain is is often due to the rubbing of a large tendon - the ilio-tibial band (ITB) over the bony prominence of the hip- the greater trochanter. This can cause inflammation of the the film of tissue in-between these two structures - the bursa. The condition can also occur with tears or inflammation of the tendons around the hip joint, trauma and following hip replacement surgery.
Symptoms can be exacerbated by prolonged standing, lying on the affected side and high impact activities. The highest incidence is in the 40 to 60 years age group. This condition predominantly affects females with a female:male ratio of 4:1.
The diagnosis is usually confirmed by tenderness over the lateral aspect of the hip. In some patients there is weakness of the hip muscles. X-rays are usually normal. The diagnosis can be confirmed by the response to an injection of local anaesthetic. If there is further doubt an MRI scan may be necessary to look for damage to the hip tendons ( tears), fluid collections, inflammation and and to plan future treatment options such as ultrasound guided injections.
Treatment is non- operative with physiotherapy, anti- inflammatories medication, steroid injections and pulsed therapy with shock wave lithotripsy. Surgery is occasionally necessary to release the tight ITB and to repair torn tendons.