Circle Nottingham’s hip department provides the very best clinical care for our patients by combining the expertise and experience of leading orthopaedic consultants with access to the latest diagnostic technology.
Our orthopaedic hip consultants are able to request a range of diagnostic techniques to complement their expert clinical assessment, to ensure the best options are taken at every stage of your injury process.
The diagnostic imaging department is supported by our radiology consultants who provide additional expertise where more specialist diagnostics are needed or where more detailed radiology reporting is required.
Our holistic approach to hip surgery means that our patients are fully supported pre- and post-operatively by our dedicated team including physiotherapy, occupational therapy and orthopaedic nurse specialist.
The close working relationship between our orthopaedic team, as well as the detailed protocols our orthopaedic department have developed for hip operations, ensures a rapid return to activities of daily living and sports can be achieved. Circle Nottingham’s short stay unit offers private bespoke care for you to recover with ease and with specialist physiotherapy support
The hip joint is a ball and socket joint designed to allow efficiency during several different tasks. These tasks include walking, squatting, running and lateral movement which is needed for many sports.
In order to perform this diverse range of tasks as well as weight-bear and transfer the body’s load, a fine balance is needed between leaving enough range of motion and providing enough stability.
Many operations carried out on hips are aimed at addressing problems in the hips associated with maintaining this balance.
Keyhole surgery for hip impingement (femoro-acetabular impingement or FAI) is commonly offered, as this condition significantly stiffens the hip motion and can cause problems sitting and playing sports.
Similarly, degenerative hip arthritis (osteoarthritis) is an extremely common condition leading to severe hip stiffness. When hip arthritis becomes advanced, surgery may be offered.
For younger individuals who require surgery due to genetics or previous trauma to the hips, the problem may be addressed with a hip resurfacing operation, although most individuals will be offered a hip replacement operation in this scenario.
Another common hip condition is caused by a combination of inflammation of a fluid-filled sac in the side of the hip and pain in the tendons of the gluteal muscles. Known as greater trochanteric pain syndrome, in rare circumstances when these tendons have torn badly, a surgical repair may be considered.
Other muscle and tendon tears around the hip are extremely rare, but under extreme circumstances surgical repair can be required.
Despite the range of surgical options available, in many cases these hip conditions can also be managed with graded hip-strengthening programs under the supervision of a musculoskeletal physiotherapist. Occasionally, image-guided hip joint injections can also be offered.
Our orthopaedic hip consultants will initially spend time to get a full understanding of your individual symptoms. Factors such as the timeline of your condition, any contributing traumas or any repetitive occupational or sports-related positions or movement that cause the pain will be taken into account.
Some hip conditions may have associated symptoms such as giving way, clunking or an inability to weight-bear through the leg. These symptoms can often be helpful in formulating possible diagnoses.
A thorough physical examination will be conducted of your hip joints. This may include a spinal exam and an assessment of some of the soft tissue structures and muscles around this area. Specialist assessment techniques may include:
- Assessing posture of the spine and lower limb
- Range of motion tests, which may give an indication of degenerative changes or hip impingement
- Assessing spinal range of motion
- Nerve tension tests to screen for any spinal or nerve cause for hip pain
- Palpation (feeling the tissues under the skin to assess for pain)
- Resistance tests, to check the integrity of the gluteal muscles and tendons
State-of-the-art diagnostics available for you
To reach the most accurate diagnosis prior to offering treatment, your hip consultant may request several types of imaging, including:
- X-rays: useful when assessing the degree of any degenerative changes to the hips. X-rays taken at specialist angles may also be useful in determining whether there are any genetic problems with the hip’s anatomy, or any evidence of bony abnormalities predisposing to hip impingement syndrome.
- CT scans: can often be useful when imaging the bony architecture in more detail for stiff and painful hips.
- MRI scans: may be considered for inspecting the soft tissue around the hip joint, or when inspecting the cartilage covering the socket (known as the labrum). In some cases, it may be necessary to inject a specialised contrast dye into the hip joint prior to the scan being performed, as this can enhance any hip labral tears present.
- Ultrasound: In instances of greater trochanteric pain syndrome or any tendon tear being suspected, an ultrasound scan may be requested to image the relevant structures.
You will always be given the space and time to talk about how your symptoms have affected you. Your individual goals will also be thoroughly discussed to determine the best possible management plan for you.
As well as offering the best possible surgical outcomes, where required our orthopaedic hip surgeons are also able to administer or refer on for image-guided hip injections or rehabilitation with our specialist physiotherapists.
Research indicates that when the right treatment is delivered by experienced orthopaedic surgeons with other services including radiology, physiotherapy, occupational therapy and an orthopaedic nurse specialist providing support in a specialist environment, outcomes for patients improve.
Our hip service includes:
- Expert assessment from an experienced consultant
- Diagnostic imaging, with no waits
- Latest imaging techniques
- Leading surgical techniques available
- Experienced musculoskeletal physiotherapists and advanced rehabilitation equipment
- Communicative working environment to ensure all of our specialists work towards your goals
Many problems that are treated with hip surgery - including hip replacement procedures, hip arthroscopy procedures including osteotomy (bone removal) and cartilage repairs to the labrum - only benefit patients significantly once a lengthy period of rehabilitation has been completed.
At Circle, our hip surgeons carefully monitor our patients progress and have a very close working relationship with the musculoskeletal physiotherapy department.
Furthermore, immediately post operatively we offer treatment solutions through our ward-based physiotherapists. These include demonstration of exercise technique as well as tutorials on how to use walking aids safely.
Once discharged, patients can still benefit from our outpatient musculoskeletal physiotherapy service which is able to offer regular and convenient appointments, with flexible scheduling available to ensure convenience for each individual.
Circle Nottingham’s clinical values ensure our patients are able to return to their goals of activities of daily living and sports, faster and stronger.