Conditions

  • Hip arthritis is wear of the smooth cartilage lining the hip joint. It isn't dangerous, but it can cause gradually worsening pain and stiffness that affects walking, sleep, hobbies and everyday life. Treatment ranges from physiotherapy and injections to hip resurfacing for active patients and hip replacement, including robotic surgery.

  • Hip impingement (femoroacetabular impingement) happens when an abnormal shape of the ball or socket causes them to contact too early as the hip moves. Over time this can cause pain, damage to the labrum and cartilage, and eventually arthritis. It is usually treated first with physiotherapy and activity changes. When symptoms persist, keyhole (arthroscopic) surgery can reshape the bone and repair the labrum, and some patients benefit from realigning the bone (osteotomy).

  • The labrum is a rim of cartilage around the hip socket that helps to seal and stabilise the joint. A tear can cause groin pain, clicking, catching or a feeling of the hip giving way. Tears are often linked to impingement. Many improve with physiotherapy, and persistent symptoms can be treated with keyhole surgery to repair the labrum.

  • Pain on the outside of the hip is very common, particularly in women over 40 and may be associated with certain surgical techniques used in total hip replacement surgery. It is most often caused by:

    • gluteal tendinopathy (irritation and weakening of the gluteal tendons)

    • gluteal tendon tears

    • trochanteric bursitis

    These conditions are painful but fortunately not serious. Most improve with targeted physiotherapy, sometimes with an injection, including PRP. Surgery to repair a torn tendon is needed only for some patients.

    Read more about pain on the side of the hip

  • Hip dysplasia is a shallow hip socket, and avascular necrosis is loss of blood supply to the ball of the hip. Both can lead to pain and early arthritis in younger adults. Depending on the stage, treatment may include joint-preserving surgery, hip resurfacing or hip replacement.

  • Hip replacements can become painful or problematic over time, for example through loosening, dislocation, infection, wear or irritation of nearby tendons. Patients with older metal-on-metal hips may also need regular checks. Problematic hip replacements can be investigated and, in many cases, successfully treated with keyhole (arthroscopic) surgery or revision surgery. Mr Raymond also offers second opinions for patients concerned about their hip replacement.

  • These injuries usually follow a sudden forceful stretch or contraction, such as a slip, a fall or a sporting injury, and happen in active adults of all ages, not just athletes. They can cause pain, ongoing weakness and, with hamstring injuries, difficulty sitting and tingling down the leg. Complete hamstring tears are best repaired early, so prompt assessment is important. Treatment ranges from physiotherapy to surgical repair.

  • The causes of groin pain are numerous. It is commonly due to:

    • the hip joint, including impingement, labral tears and arthritis

    • a stress fracture

    • a hernia

    • a sportsman's hernia

    • adductor tears

    • iliopsoas tendinopathy, which can be associated with a hip replacement or resurfacing

    A careful assessment and examination will enable diagnosis and appropriate treatment.

  • Mr Raymond is also fellowship trained in the treatment of knee arthritis, meniscal (cartilage) tears and ligament injuries, with treatment ranging from physiotherapy and injections to keyhole surgery and knee replacement.

Medical illustration of a hip joint showing inflammation or injury, with the hip socket and upper part of the thigh bone illuminated.