Professor Xavier Griffin – Consultant Orthopaedic Surgeon at The Foscote Hospital, Banbury discusses hip pain and the medical help that is available.
In my clinical practice, I treat many people who have developed wear and tear in their hip joints and also those who have injured them. A broken hip is the commonest fragility fracture that brings people into the hospital and a hip joint replacement is one of the commonest operations for arthritis conducted in the UK. More than 85,000 hip replacements were performed in 2016 alone.
Am I affected by arthritis?
Commonly referred to as wear and tear, osteoarthritis of the hip is very common. Approximately 1 in 20 adults in the UK is troubled by pain from their hip joints that can be attributed to osteoarthritis. As we age, the likelihood of arthritis increases. The average age of people having hip replacements in the UK is 68 years. If you commonly feel pain deep in your groin, or sometimes buttock, especially brought on by activity, have a limited walking distance or struggle with stiffness preventing you doing simple things like tying shoelaces, then you may be suffering from arthritis of your hip. These symptoms often come on very gradually over time and you may not remember anyone specific time or event that caused them.
What can I do to help my pain?
You are able to make important changes in your lifestyle that might really improve your pain and other symptoms. Activity such as regular walking or another exercise for ten minutes a day, will keep you generally healthy and help with your muscle strength and tone. If you are a little overweight then reducing this will substantially improve your symptoms as the joints of your legs will improve as your weight comes down. Other changes such as reducing high impact sport and taking up other options such as cycling or swimming can also be beneficial. Traditionally, we would have prescribed painkillers to help, such as paracetamol or anti-inflammatories. However, the most recent studies suggest that paracetamol is ineffective and anti-inflammatories may have side-effects if taken long term. The good news is that glucosamine, a common supplement available in health food shops, may help some patients and is very safe indeed.
When to seek help
There are no hard and fast rules for when you should seek advice from your doctor or a hip surgeon about arthritis. If your symptoms have had an impact on your life and are not improving with simple measures then they should be taken seriously. If your work or hobbies have become difficult, you need to use a stick or crutch, or you have persistent pain or pain that wakes you from sleep you may benefit from discussing surgical options.
What does hip replacement surgery involve?
The hip is a ball and socket joint lined by cartilage and lubricated with a special fluid called synovial fluid. At some point, which is different for everybody, the severity of their symptoms can mean that surgery is the best option to improve their pain. In hip
replacement surgery the ball and the socket are both replaced – most commonly with a metal ball and a socket made from a type of polyethylene or plastic. There are several variations of hip replacements available and the choice of which one is most suitable is made after discussion with your surgeon. The recent news coverage of problems with hip replacements causing pain and further surgery is only relevant to a very specific type that is used very infrequently now in the UK.
What can I expect after surgery?
You will be in the hospital for a short time after surgery while your physiotherapist helps you to rehabilitate. Your hip replacement is ready for you to walk on immediately following your surgery and everyone is encouraged to get up on the day of, or the day after their operation! The average length of stay in the hospital after a hip replacement in the UK is now less than three days. The surgery is very safe and the vast majority of patients do not suffer from any complications.
Will my hip pain improve?
Hip replacement is the only definitive surgical treatment for established osteoarthritis of the hip. Based on information collected from all patients undergoing hip replacement in the UK, nineteen out of twenty people report an improvement in their hip function and pain relief following hip replacement. Hip replacement is the most cost-effective operation offered in the UK and is a benchmark procedure against which many other treatments are compared.