Typical Treatments Undertaken by Hip Surgeons
In addition to those patients with a serious traumatic injury to the joint and who require emergency surgery, a fair proportion of the work routinely undertaken by hip surgeons is likely to be of an elective nature. Patients in this category tend to have a disorder of the joint that is currently being managed by some form of pain medication and, perhaps, physiotherapy, which over time, can be expected to cease being effective and will, therefore, at some future date, necessitate a more long-term solution.
The focus of these specialists is on the single joint responsible for the smooth articulation of the ball-like head of the femur within the socket-like acetabulum. There are a number of anomalies that can interfere with its smooth operation, resulting in inflammation, swelling, and pain, and reducing free movement of an affected joint. It is the task of hip surgeons to determine the nature of these anomalies and, where indicated, to perform an appropriate surgical intervention
Their first steps will be to confirm a diagnosis and to evaluate the extent of the problem, in order to decide on the best way forward. X-rays and more advanced medical imaging may provide sufficient information, but there are occasions when a closer look at the interior of the joint becomes necessary. For this purpose, there is a special instrument known as an arthroscope. Like a narrow telescope, when inserted into the joint via a tiny incision, it returns a magnified, real-time video image of the bones and surrounding tissues in full colour. Arthroscopy enables hip surgeons to make a much more accurate assessment of any damage to the joint and of the type of intervention required.
No longer just a diagnostic procedure, arthroscopy is frequently used to perform a number of minimally-invasive orthopaedic procedures. Typical applications for this form of keyhole surgery include the removal of loose particles of bone or cartilage and repairs to a torn cartilage.
Even though, today, the risks associated with surgery are minimal, it is an option that will generally be avoided until absolutely necessary. For example, where joint damage is considered insufficient to warrant an operation, hip surgeons will often choose to administer a hip block injection instead. Performed using X-ray guidance, a mixture of a local anaesthetic and a steroid is injected directly into the joint to provide the rapid and long-term pain relief and anti-inflammatory action that are not possible with oral medications. Additional treatments at intervals can delay the need for more radical measures substantially.
Ultimately, however, a total or partial joint replacement will be the only way to provide further pain relief and restore mobility. Known as arthroplasty, these procedures are generally accepted within the profession as the safest and most successful interventions in the history of orthopaedic surgery. In a total replacement, both the head of the femur and the damaged acetabular socket with a prosthetic joint made of metal, plastic, or ceramic, whilst when performing partial replacements, hip surgeons only replace the femoral head.
Depending upon the amount and nature of usage, and barring accidents, these prosthetic joints have a lifespan of between 10 and 20 years at which point hip revision surgery to replace all or part of the prosthetic joint will also be the responsibility of these orthopaedic specialists.