Hip surgery & preservation.
Fellowship-trained in young-adult hip preservation at the Royal National Orthopaedic Hospital in London and complex hip arthroplasty at Southmead Bristol. Hip Conditions and Hip Surgery on one page — every condition and every procedure.
Specialist diagnosis & non-surgical care first.
Comprehensive management of adult and adolescent hip conditions — including arthritis, femoro-acetabular impingement, labral tears, avascular necrosis, and painful or worn previous hip replacements.
Hip Arthritis
The most common reason for hip replacement — osteoarthritis, inflammatory and post-traumatic arthritis. Anatomy, symptoms (groin pain, stiffness, grinding), X-ray diagnosis, non-surgical treatment, and total hip replacement.
FAI & Labral Tear
Femoro-acetabular impingement (CAM and pincer types) and labral tears — groin pain with activity that worsens with sport or sitting. 60% respond to non-surgical care; hip arthroscopy for persistent symptoms.
03 · Condition
Avascular Necrosis
Avascular Necrosis
Avascular necrosis disrupts the blood supply to the femoral head, leading to bone death and eventual collapse — most commonly seen between ages 30–50.
Risk factors: trauma, alcohol, steroids, diving, sickle cell, chemotherapy.
Symptoms: groin or buttock pain that progresses over months.
Diagnosis: X-ray (may be normal early), MRI required for definitive diagnosis.
Treatment: core decompression (50–80% success preventing collapse if treated early), total hip replacement for advanced disease.
04 · Condition
Painful / Worn Hip Replacement
Painful / Worn Hip Replacement
A previously well-functioning hip replacement may begin to fail. Six common mechanisms: loosening, wear, infection, dislocation, fracture, and metal reaction.
Symptoms: new pain in a previously comfortable joint.
Investigation: X-ray, CT, MRI, bone scan, and blood tests.
Treatment: conservative monitoring for minor issues, or revision surgery — see Revision Hip Surgery for full details.
Five procedures, one fellowship-trained surgeon.
Primary and revision hip replacement using minimally invasive anterior approach where suitable; arthroscopic keyhole treatment of labral and FAI pathology; complex revision work; and proximal hamstring repair.
Total Hip Replacement
90-minute surgery, 2–3 nights in hospital, crutches for 2–4 weeks. Modern implants: 90%+ last 10+ years; 70%+ last 20+ years.
Anterior Approach Hip Replacement
Incision on the front of the thigh, passing between muscles without cutting tendons. Lowest dislocation rate (0.2–0.5%), no hip precautions post-op.
Hip Arthroscopy
Camera and instruments through 2–3 small incisions under general anaesthesia with leg traction. Treats FAI, labral repair, loose body removal, microfracture. Not for hip arthritis.
Revision Hip Surgery
Any surgery re-doing parts of a previous hip replacement. Indications: loosening, wear, infection, dislocation, fracture, metal reaction. Spinal anaesthesia, approx. 4 hours.
- ·Hospital stay 2–7 nights
- ·Crutches 6 weeks; full recovery several months
- ·90% success resolving infection and dislocation problems
- ·Higher risk profile than primary replacement
Proximal Hamstring Repair
All three hamstring tendons detach at the pelvic attachment — severe buttock pain and difficulty walking. MRI confirms the diagnosis. Non-surgical leaves around 50% strength; surgical repair restores around 90%. See the dedicated Trauma page.
Conservative first. Surgical when the evidence supports it.
Non-surgical care — physio, weight management, anti-inflammatories, cortisone injections — clears around 60% of FAI presentations. Surgery is reserved for when imaging and symptoms point clearly in that direction.