SERVICES
HIP SURGERY
HIP REPLACEMENT
HIP REPLACEMENT
During this procedure, your damaged hip joint is replaced with implants that recreate the ball and socket of a healthy hip. This can reduce pain and restore your hip function. The most common factor contributing to the necessity of joint replacement surgery is osteoarthritis.
Learn more part will include:
Am I a good candidate for a hip replacement?
You are a good candidate for a hip replacement if:
• Your hip pain interferes with your normal, routine activities
• Physical therapy and conservative management have not helped to control your hip pain
• You have imaging findings demonstrating significant cartilage loss or damage or advanced osteonecrosis, a condition caused by abnormal blood flow to the femoral head (the “ball” in the ball and socket joint)
What are the benefits of a total hip replacement?
A total hip replacement provides the following benefits:
• Alleviation of your hip pain and increased mobility of the hip
• Return to your normal, everyday activities
• Involvement in limited sports activities such as golf, tennis, and walking
What can I expect from hip replacement surgery?
• A complete pre-operative workup that will focus on preparing you for your minimally invasive hip replacement
• One-to-two-hour surgery time
• One to three nights stay in the hospital, with physical therapy beginning the day following surgery
• A comprehensive pain management protocol, reducing your dependence on pain medication day by day
• Return to basic daily activities within 2-3 weeks
• Return to relatively normal activities by 2-3 month
FEMORAL ACETABULAR IMPINGEMENT
Overview
Your hip is the joint where your thigh bone meets your pelvis. The hip is a ball-and-socket joint made up of the acetabulum and the femoral head, which is the upper end of the femur. Articular cartilage over the ball and the socket allow the bones within the joint to glide over one another smoothly.
In a healthy hip, the femoral head fits perfectly into the acetabulum. But an ill-fitting joint will cause friction leading to femoroacetabular impingement. The joint may be ill-fitting if the bone overgrows or bone spurs develop within the hip joint, or if the femoral head is not round. In some cases, both these impingements are present.
Cause
An ill-fitting hip joint usually develops in the growth phase during childhood. When this ball-and-socket joint doesn’t fit correctly, over time, it leads to joint damage and pain diagnosed as femoroacetabular impingement.
Symptoms
While many people with hip impingements go on to live their lives with few symptoms, others may experience painful symptoms as a result of damage to the cartilage or labrum, and the disease is likely to get worse.
Symptoms include:
- A dull ache or pain near the inner hip, or groin area, usually after walking, or prolonged sitting.
- A locking or catching sensation of the hip joint
- Difficulty walking
- Pain in the lower back, the buttock, or the side of the hip
Treatment
Non-surgical treatment of hip impingement or femoral acetabular impingement usually involves rest, anti-inflammatory drugs and pain medications. Physical therapy can also be done to improve the range of motion in your hip and strengthen muscles surrounding the hip joint.
In cases where symptoms are not alleviated by a conservative approach, and the MRI scan shows that the hip joint has been damaged, Dr Pienaar may advise surgery. In such cases, arthroscopic surgery may be done using small incisions and thin instruments. During arthroscopy, your surgeon inserts an arthroscope through a small incision. This arthroscopy is fitted with a camera to allow Dr Pienaar to visualise the internal joint on a monitor, while other surgical instruments are inserted through separate incisions to remove bony spurs or bumps, repair the damaged labrum and articular cartilage in the joint. In some cases, this may require open surgery.
HIP LABRAL TEAR
Overview
The hip joint is a ball-and-socket joint made up of the acetabulum (the socket), and the femoral head (the ball). Within the hip joint, there is a ring of cartilage that follows the outside rim of the acetabulum. This is known as the labrum and acts like a rubber seal to hold the ball of the thighbone in position and allow it to move smoothly. A tear to the labrum is known as a labral tear and is often caused by sporting injuries.
Cause
While a labral tear is commonly caused by injuries during sports such as hockey, soccer, football, golf and ballet, structural abnormalities of the hip can also cause a tear in the labrum. Femoroacetabular impingement (FAI) and osteoarthritis are also common causes.
Symptoms
Those with a labral tear in the hip will typically experience pain during exercise or when bending, moving or rotating the hip. While many with a hip labral tear experience no symptoms, symptoms may include:
- Catching or locking of the hip
- A clicking sound when moving
- Sharp pain in the hip, buttocks or groin area
- Stiffness in the hip joint
Treatment
Treatment for a labral tear of the hip will depend on the severity of the symptoms. For some conservative treatment options such as anti-inflammatory medications, physical therapy and pain management may be all that is needed. For others, arthroscopic surgery may be needed to repair or remove the torn portion of the labrum. This is a minimally invasive surgery in which thin tube-like instrument fitted with a camera at the end is inserted through small incisions to allow Dr Pienaar to visualise the joint, and perform surgery. From there, the pieces of the torn labrum can the be removed (this is known as debridement) or repaired with sutures.