13 July 2010 | Mr Manoj Ramachandran | Paediatric and Young Adult Orthopaedic Surgeon | The Portland Hospital | Based at St Bartholomew's and The Royal London Hospital, London.
According to Mr Manoj Ramachandran, Consultant Paediatric and Young Adult Orthopaedic Surgeon at The Portland Hospital, the causes of hip and groin pain, and associated clicks and clunks, have previously been difficult to diagnose and treat in both young adults (women aged up to 50) and adolescents (boys and girls aged 13-19 years old). Recently, there has been a growing interest in using minimally invasive keyhole surgery (arthroscopy) to assess the hip joint and to treat any underlying conditions.
Hip and groin problems in young people present with hip, groin, thigh or low back pain and there may even be feelings of clicks and clunks.
The symptoms are often experienced during activity (e.g. sports involving twisting, pivoting, cutting and squatting) or during certain positions of the hip joint (e.g. when sitting for prolonged periods or turning the hip joint inwards). A thorough history and examination, combined with focussed investigations such as MRI scanning with dye tests, can pinpoint any underling pathology in the hip joint, such as tears of the lining of the joint (cartilage or labrum), extra bumps of bone (impingement), loose bodies or tight muscles and tendons.
Until recently, the only method of accessing the hip joint surgically for these pathologies was by open surgery requiring a large incision and prolonged recovery on crutches without weight-bearing for several weeks. Mr Ramachandran is one of a small number of surgeons in the UK who is pioneering the use of hip arthroscopy to treat these conditions. With the purchase by The Portland Hospital of the latest Full 1080p High Definition (HD) camera technology from Karl Storz Endoscopy, the Portland can now offer world-class hip arthroscopy services to both young adult women and adolescents.
The surgery is often day case, such that the vast majority of patients are home within 24 hours. Access to the hip joint is via two to three small (around 5mm) incisions and the entire hip joint can be visualised in high-definition and any underlying problem treated. Most patients are on protected weight-bearing with crutches for two weeks after which the hip joint can be further mobilised with the help of physiotherapy as required. Sample images of the hip joint obtained during keyhole surgery can be viewed at www.londonpaediatricandadultorthopaedicsurgeon.co.uk/hip-arthroscopy.html
Mr Ramachandran believes that finally there is an option for young people to obtain minimally invasive surgery of the hip to treat their underlying problems whilst minimising complications and time for recovery.
For further information please contact Mr Manoj Ramachandran, Paediatric and Young Adult Orthopaedic Surgeon at The Portland Hospital Outpatients Department on 020 7390 6504.