The Problem Hip


The first recorded attempt at hip replacement occurred in Germany in 1891 using ivory to replace bone. However the first clinically successful replacements were performed in the 1950s and 60s by Professor John Charnley in Manchester. Technology has come on enormously since then and now 160,000 replacements are done every year in England and Wales with success rates running at around 96%.
This is a very common problem usually affecting older people. In my experience some cases are long term (chronic) in which the hip will gradually stiffen up but then grumbles on for years with only minimal deterioration and often manifests as episodes of pain. Others come on more acutely and deteriorate rapidly with a downhill path that leads to the surgeon’s door within months. As an Osteopath it often surprises people that I am very much in favour of hip replacement surgery. I think there is a strong case to have the surgery early as this avoids prolonged periods of limping which damages the spine and other joints which cannot be replaced.
Greater trochanteric pain syndrome
Of course many pains around the hip area are not caused by osteoarthritis and do not require surgery. I see huge numbers of cases of greater trochanteric pain syndrome which used to be called trochanteric bursitis. Most of the pain is in the buttock and down the outer side of the thigh (osteoarthritis of the hip is commonly felt in the groin and front of the thigh). Currently this is thought to relate to a dysfunction of the tendon of one of the buttock muscles.
Acetabular labrum tear
Since the advent of MRI scanning this has become a much more common diagnosis. The condition is caused by a tear in the lining of the socket of the hip and shows up as a “catching hip”. Specialist MRI is used for diagnosis and surgical repair usually fixes the problem.