Hip Preservation Service

Arthroscopy of peripheral compartment of the hip joint.

The native hip joint is a wonderful structure, which tolerates forces in excess of seven times the body weight, and functionally is far superior and more stable than any man-made hip replacement system. It is, therefore, a no brainer to preserve the native (patient’s own) hip joint. The specialist Hip preservation service is aimed at just doing that.

At The Villar Bajwa Practice, a structured approach is taken towards hip joint preservation while treating problems around the hip joint. The Hip preservation service has adopted a multi-disciplinary approach, which involves the Sports Medicine specialist, Physical therapy specialist, Sports Psychologist, Musculoskeletal Radiology expert, Pain specialist, Gait analysis expert and Specialist Hip surgeons working in unison. The Practice is led by two eminent orthopaedic surgeons, Richard Villar and Ali Bajwa who aim to offer both preventative advice and treatment of problems around the hip and groin.

At the Hip Preservation service we endeavour to avoid surgical intervention as far as possible, however if surgery is unavoidable then we tailor the treatment for the individual patient while keeping the intervention to a minimum. There are a few scenarios though, where undue delay in surgical intervention may be to the detriment of the Hip joint, and clearly in those circumstances we advise a more aggressive approach.

The Hip Preservation Service deals with various problems including;

  • Early wear and tear in the weight-bearing part of the hip joint, which may need gait and posture re-education, range of motion therapy, training modification, optimisation of analgesia (pain-killers), joint preservation therapy such as lubrication injection, Platelet Rich Plasma (PRP) therapy, repair of cartilage using key-hole surgery and adult stem cell therapy in selected patients.
  • Moderately significant arthritis in a patient who would like to try and gain some more time to avoid or delay artificial joint replacement surgery. This is a very challenging group and generally requires a multifaceted approach.
  • Femoroacetabular impingement and its consequences such as Labral tears and cartilage flaps. The emphasis is on retaining and repairing, rather than cutting and chopping. All patients do not require surgical treatment, however if surgery is required then this is carried out through the key-hole (arthroscopy).
  • Lateral thigh (outer side of hip) pain around the Greater Trochanter is dealt with. Such pain may stem from torn abductor tendons around the hip, bursitis, spurs, referred pain from another source such as back and, occasionally, from the hip joint itself.
  • Problems with tendons around the Hip joint, which include Piriformis syndrome, Adductor and Hamstring tendon tears and tendinopathy. Most of these are amenable to non-surgical or minimally invasive treatments.
  • Sciatic nerve entrapment at the level of the Hip, Ischio-femoral impingement and Iliopsoas tendon problems. A trial of non-operative treatments is usually undertaken with these at the Hip Preservation Service including injection therapies. Some of the patients who fail to respond or only have temporary benefit may require arthroscopic (key-hole) surgery.

Since the hip joint is closely related to the groin, the hip pain can be produced by entities such as sports groin hernia, which are screened and identified at the service. The Hip Preservation Service has close links with experts in this particular area and we do not hesitate to get their help in dealing with these problems in a small subgroup of our patients.