It was not so long ago when a fracture of the pelvis or marked wear and tear of the cartilage that protects the articulating surfaces of its internal structures would have, almost invariably, led to the patient spending the remainder of their lives in a wheelchair. Today though, following numerous advances in technology and improved techniques since developed by specialist hip surgeons around the world, these conditions and others that might otherwise limit a person’s ability to walk, can generally be treated with a high degree of success.
There have been a number of milestone events that, together, account for this change of fortune. One of the first to have a positive impact on the treatment of such patients was the discovery of X-rays by Wilhelm Röntgen, in 1895. The apparatus that followed offered a means to perform a non-invasive inspection of a damaged or diseased joint which then helped to provide the hip surgeons of the time with a better idea of whether and how best to intervene.
An even more significant breakthrough occurred around two decades later with the first use of a modified cystoscope as a means to obtain a direct view of the interior of a joint. The instrument in question, which later became known as an arthroscope, was first used by a Tokyo professor, namely Kenji Takagi, to examine a knee joint. Its subsequent success as a diagnostic tool and, later, as an aid to performing minimally invasive procedures on the knee, provided the foundation for its later use by pioneering hip surgeons.
Repairs to fractures of a long bone, such as the tibia or ulna, can often be treated by reduction and immobilisation alone. More complex fractures, however, can be successfully treated by surgical insertion of suitable pins, screws and rods. Most attempts to effect repairs to a damaged joint, however, will invariably require some form of surgery. Arthroscopic inspection of a joint has since become a routine orthopaedic procedure and one that is now widely used by the world’s shoulder, knee and hip surgeons.
The ability to view the inner structures of a joint has enabled the orthopaedic specialist to better evaluate the nature and extent of any disease or damage that may be affecting it and to decide upon the most effective treatment. When leaving the scope in position, though, it also becomes possible to monitor the movement of surgical instruments introduced through additional keyhole incisions. While, once again, this is a procedure that was first used as a minimally invasive alternative when making repairs to the knee joint, arthroscopic surgery has since been adopted by many hip surgeons also. Generally reserved for younger patients, it can help to reduce bleeding, the risk of infection, and post-operative recovery times.
The pinnacle of achievement for those surgical specialists whose main field of interest is the articulation between the pelvis and femur is undoubtedly the procedure known as hip arthroplasty. Most commonly performed as a means to counter the erosion of cartilage caused by osteoarthritis, it involves replacing the lining of the acetabular socket and the head of the femur with prostheses, to form an artificial joint. Today, tens of thousands of previously immobile patients are grateful to hip surgeons for changing their lives.