Compared to joints such as the knee or shoulder, the hip is deep inside. Although you can feel the prominent bone at the top of your thigh, that isn’t the hip joint. The closest you can get to it is to press deep into the crease of your groin, and even then you can’t really feel the joint.
Working with an international group of innovative surgeons, we have developed techniques that allow us to perform a remarkable range of operations through tiny incisions, and allow patients to recover far more quickly than with conventional surgery. Our idea is to work inside the hip while doing as little damage as possible to the muscles and ligaments that surround it.
With the patient asleep, we use X-ray imaging to help us find our way safely in between the ball and the socket, and insert a camera so we can see all around the hip. In our hospitals, we are very lucky to have two operating theatres that were specially designed to make this particular operation as safe and easy as possible. Once inside, we can find our way around using a map of images and 3-D models of that person’s hip that we prepare in the clinic. Tiny instruments can be inserted through quarter-inch incisions to remove loose fragments, repair cartilage, stitch ligaments or reshape bone.
Because of the magnification of the camera on a big screen, the surgeon can be very precise and the keyhole technique means that patients recover very quickly. Almost all will get out of bed and walk on the day of their surgery, and most will have a session in the gym working with a physiotherapist on an exercise bike on the afternoon of their operation. In fact, we think that rehabilitation is so important that we want to start straight away!
Not all problems can be treated with arthroscopic surgery. Sometimes, the damage to the hip is too extensive, or the correction required is too substantial; in these circumstances, an open operation may be necessary. Most commonly, this will involve surgical dislocation of the hip, peri-acetabular osteotomy, or proximal femoral osteotomy. Some patients require a combination of these procedures.