Hip Replacement Pain Groin Stiffness Arthroplasty Revision Fracture
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    Hip Clinic
    Hip Review Clinic
    Hip Revision Surgery

I have treated patients with hip pain for many years and have seen a wide variety of common and uncommon conditions. They say "you never miss something 'til it's gone", this is especially true of a functional hip joint.

Range of movement in the hip joint
Mr Gavin Holt

Mr Gavin M Holt
Consultant in Trauma & Orthopaedics
Qualified Aberdeen, 1988

Specialist Hip and
Knee Surgeon

Private Secretary
Lorraine McNickle
01242 246500
07989 896473
Normal everyday activities require a good range of hip movement and power to drive the leg. Sport and recreation can significantly limited by persistent hip or groin pain. Giving patients back near normal levels of activity is one of the great rewards of hip 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 hip

There 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 problems

Accurate 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 problems

In 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 replacements

Regular 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.

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