3 Most Common Hip Surgeries
Hip replacement:
Total hip replacement is one of the most successful and cost-effective orthopedic surgeries. In this procedure, damaged bone (Parts of the hip bone and femur) and cartilages are removed and replaced with prosthetic components.
Indications for surgery could be:
Trauma: Fracture of femur and/or hip bone due to fall, motor vehicle accidents
Avascular necrosis of hip: The condition in which blood flow to the hip bone is disrupted due to various reasons, which causes death of bone tissue.
Dysplasia of the hip: Hip is a ball and socket type of joint. In this condition the socket of the hip bone is too shallow to hold/support the ball (Head of the femur), which results in partial or complete dislocation of the joint.
Hardware failure after internal fixation of hip fractures
2. Hip arthroscopy:
This procedure is less invasive compared to THR and causes less trauma to tissues as well as less post-surgical complications. It involves small incisions and the use of a camera to view inside of the joint to treat or fix the issue.
Indications for this surgery could be:
Femoro-acetabular impingement: In this condition, there is an abnormal contact between 2 bones of the hip joint: Acetabular rim(Hip bone) and proximal femoral head. It causes pain during weight-bearing activities and damage in the soft tissue within a joint.
Labral tears: The function of the labrum is to provide cushioning and stability to the joint, which is a cuplike structure lying on the surface of the acetabulum (Socket of the hip). Tears in the labrum due to various causes can lead to pain, reduced mobility and instability in the joint.
Greater Trochanteric pain syndrome: This involves tendinopathy of different muscles like, Gluteus Medius, minimus. It causes pain in the lateral (outer side) thigh that triggers prolonged sitting, lying on the same side, going upstairs and high impact physical activities.
Osteoarthritis: Degenerative changes in joint surfaces and cartilages, if it’s still in early stage, there can be some symptomatic improvement from arthroscopy.
3. Hip Labral Repair:
As mentioned earlier, Labrum is a cushion between 2 bone surfaces in the joint. This can be torn or damaged due to trauma, arthritis, femoro-acetabular impingement, dysplasia or repetitive motions in athletes. People with labral tears may have symptoms like, pain in groin, anterior side of the hip (Front), clicking, locking or giving away.
This procedure is also done via arthroscopy with minimal invasion.
Common Complications from Hip Surgeries:
Deep vein thrombosis
Infection
Leg length discrepancy
Bursitis
Mild peripheral nerve injury
Instability or weakness
Scarring and adhesions
Persistent pain or stiffness
Pre- and Post-surgical Physiotherapy Assessment and Treatment to Avoid Complications:
Research shows that Thorough assessment and physiotherapy treatment before surgery reduces risk of developing any post-surgical complications and aids in better recovery. Pre-surgical assessment and treatment involves Health history, specific risk factors, Education, precautions, home exercise program, strength and mobility training for adjacent joints. Post-surgical physiotherapy can start as soon as Day 1 or as per your surgeon’s prescription. The personalized treatment approach helps individuals to achieve their short term and long term goals and gradually return to previous activities, either sports-specific or work-related.
Treatment protocol involves:
Pain management
Gait training with progressive weight bearing status
Manual therapy: Joint mobilization, soft tissue release
Strength & mobility training
Balance and proprioception training
Sports/work specific exercises
Home exercise protocol
References:
Physio-pedia. (n.d.). Hip arthroscopy. Physio-pedia. Retrieved March 6, 2025, from https://www.physio-pedia.com/Hip_Arthroscopy
Physio-pedia. (n.d.). Total hip replacement. Physio-pedia. Retrieved March 6, 2025, from https://www.physio-pedia.com/Total_Hip_Replacement
Physio-pedia. (n.d.). Labral tear. Physio-pedia. Retrieved March 6, 2025, from https://www.physio-pedia.com/Labral_Tear
Physio.co.uk. (n.d.). Labral repair. Physio.co.uk. Retrieved March 6, 2025, from https://www.physio.co.uk/what-we-treat/surgery/hip/labral-repair.php
