Mr Marcus Cope MRCS MSc (Eng) FRCS (Tr&Orth)

Consultant Orthopaedic Surgeon
Specialising in surgery of the lower limb

The Hip

Why does my hip hurt?

The hip joint is a ball and socket joint. The surfaces of the two bones (femur and pelvis) in contact are covered in cartilage, a very slippy material. This allows the joint to move easily. Overtime the cartilage becomes worn and the underlying bone is exposed this then makes the joint stiff to move and causes pain. If left the joint may become so stiff that it may not move at all. Pain is often felt in the groin area but can be felt in the knee and, or buttock area (referred pain).

In the early stages of arthritis people try oral supplements such as cod liver oil, chondrotin and glucosamine to slow down the progress of the arthritis. When the pain becomes unbearable then the only option is a replacement joint.

How can Mr Cope help me?

There are several options of replacement available depending on your age, activity and quality of bone. For the majority of patients I implant a cemented Exeter total hip replacement which has an excellent proven track record, from the Swedish hip register, showing that 97% of hips are still in and functioning at 10 years. I also implant a 28mm diameter head which gives a lower dislocation risk.

The majority of my patients will have minimally invasive surgery and a cut that is typically 10cm (previously was 25cm), however this is dependant on your body shape. I will not compromise the longevity of your implant to give you a small scar. I believe that this approach whilst giving you a more discrete scar also allows for a quicker recovery as there has been less damage to your soft tissues.

The anaesthetist will either give you a general anesthetic which requires a machine to breathe for you or a spinal anaesthetic which makes your legs numb and some sedation to make you sleepy. The operation typically last one hour, however you will be in the theatre area for around two to three hours.

The next day you begin your road to recovery and start to walk, initially with walking aids. You go home typically three to five days after the operation. Around six weeks following the operation you are fit to drive and are usually walking unaided. This is meant as a guide only and all patients heal and recover at different rates.

Possible complications of surgery

The majority of patients (95%) have a successful outcome with no problems; however surgery does have risks associated with it. Some patients will have higher risks depending on the previous diseases they suffered from. These include:

The risks to all joint surgery are:
* Medical (heart attacks and strokes) (see above)
* Infection of new joint requiring removal (1%)
* Deep vein thrombosis (blood clots) (2-3%)
* Fatal pulmonary embolism (blood clot goes to lung) (0.2%)

All joint replacements are artificial and as such can wear out sooner than expected leading to another (revision) operation. There are also risks specific to the individual procedure, which include:

Hip Replacement

Dislocation (2%) - leading to further surgery on occasions.
Leg – length discrepancy (2%) - sometimes a shoe insert is needed to correct this.
Fracture of thigh bone (0.02%)
Sciatic nerve injury (0.02%) - giving a foot that you cannot lift when walking.

Hip Resurfacing

Femoral neck fracture (3%) - when the ball breaks off the shaft of the femur and requires further surgery
 

Any further concerns you have about the complications should be addressed to Mr Cope or his team when you meet him in clinic.