This is a diagnostic test in that it is sometimes used to make sure that pain is coming from the hip joint before other surgery (such as hip replacement) is planned. This is because hip pain can sometimes be referred from the back or pelvis.
Yet, it can also be a very useful therapeutic investigation. For a range of hip conditions, including osteoarthritis, it can give a good relief of symptoms from anywhere from a few months up to one to two years.
The procedure involves inserting a very fine needle into the hip joint under x-ray control then injecting a radio-opaque dye into the joint to confirm correct positioning. Once in the joint, local anaesthetic and cortisone are injected. This can be performed either under local anaesthetic or under a short general anaesthetic. In both instances the operation is performed as a day case in hospital and operating theatres.
Follow up consultation £150
Normally an hour after the procedure the patient can be got up and start to walk. Driving or operating machinery is not recommended for 24 hours after the injection.The procedure has very few risks. The anaesthetic is short and the risks from this are very small, the operation is performed in theatre to reduce the risk of infection.
The main side effect is that one in thirty patients, usually women, can get some facial flushing the day after the injection but this resolves spontaneously.
Surgery Cost £500 - £1000
Depending on location and procedure, inclusive of follow up consultation, surgery, follow up and physio/after care)
How long will I be in hospital?
Most patients will be able to leave after 2 or 3 days.
How soon will I recover?
Patients vary enormously. At six weeks most patients are considerably more comfortable and walking greater distances than prior to the operation. Many patients will have returned to work by this stage.
Your recovery will continue until four to six months after your operation. All patients are brought back to be assessed in a clinic at six weeks.
Younger patients will be kept under review for a number of years, but most patients over the age of sixty will be discharged with the expectation their hip is likely to last them for as long as they will need it.
What about work?
Most patients return to work about six weeks after their operation. Some more physically demanding jobs may require a week or two longer off work. Often patients return well before six weeks.
What about driving?
Most surgeons advise their patients not to drive for 4-6 weeks after hip replacement surgery. It is important that in an emergency you are able to stop the car safely.
What about sports?
Most patients are able to return to a high level of activity following hip replacement surgery. Repetitive loading such as running, may be possible but is more likely to wear your joint more rapidly. Activities that involve deep bending of your hip, such as certain yoga movements are best avoided. After three months riding, golf etc. should be fine.
What about day to day activities?
Whilst on the ward your physiotherapist will teach you how to safely get in and out of bed, give you advice on dressing, toileting etc. In particular, you will be told how to get in and out of bed, in and out of a car and in and out of a bath.Do not be frightened to resume normal sexual relations, being careful not to force your hip into an uncomfortable position. Initially it may be safer lying upon your operated side or back.You will be shown how to get in and out of bed on the ward. It is advisable to sleep on your back, though you may sleep on your operated side with a pillow between your knees to prevent your leg from turning in.For the first six weeks you can only have a walk-in shower or strip wash sitting on a high stool. You should not attempt to have a bath until after your first outpatient appointment. Should you then require any aids to enable you to get in and out of the bath contact Occupational Health.
What about the garden?Patients are often keen to get back to gardening. The most important point is to remember to take care picking things up off the ground and your physiotherapist will advise you how to avoid putting your hip at risk. Even heavy digging should be possible by three months.Movements to avoid following surgeryYou should avoid bending at the hip, twisting your waist and crossing your legs.