Hip replacement is one of the most successful operations in modern medicine, but it should not be the first step in management of your hip osteoarthritis. Understanding this helps you make better decisions about when and whether to act. Mr Kosuge sees many patients who are unsure whether their hip pain is “bad enough” to see a specialist. Here is how to think about it.
Recognising the early signs
Hip osteoarthritis is the gradual wearing of the smooth cartilage that lines the hip joint. The early signs are often subtle. Many people feel it first as pain in the groin rather than over the outer hip. It may spread towards the front of the thigh, or even the knee. Stiffness after sitting, difficulty putting on socks or shoes, a reduced range of movement and pain that worsens with activity are all common. In the early stages the discomfort tends to come and go, which is one reason people put off seeking advice.
What is happening in the joint
As the cartilage thins, the joint moves less smoothly and the surrounding tissues become irritated. This is a slow process and its pace varies enormously from person to person. Some people remain comfortable for years with simple measures, while others progress more quickly. An X-ray confirms the diagnosis, but the decision about treatment rests on your symptoms and how much they affect your life, not on the X-ray alone.
What to try before considering surgery
For most people the first steps are non-surgical and they are worth taking seriously. Keeping active with low-impact exercise such as swimming, cycling or walking helps maintain strength and movement. Losing excess weight reduces the load through the joint. Physiotherapy can improve the muscles that support the hip. Simple pain relief used sensibly can keep you moving. A steroid injection into the hip can also provide a period of relief for some patients. None of these measures reverses the arthritis, but they can control symptoms and, for many, delay surgery for a long time.
When it is time to see a specialist
The right time to seek an opinion is not a fixed point on an X-ray. It is when the pain is disturbing your sleep, limiting the things you want to do, or no longer responding to the measures above. Seeing a specialist does not commit you to an operation. It simply gives you an accurate picture and a clear set of options, so that if the time for a hip replacement does come, it is a decision you make on good information.
Arranging an assessment
Mr Kosuge will examine your hip, review any imaging and explain the full range of options, surgical and non-surgical. To arrange a consultation at The Rivers Hospital, High Wych Road, Sawbridgeworth CM21 0HH with Mr Kosuge:
Telephone: 01279 602675