Practical reading from Professor Paul Lee and the Lincolnshire Hip Clinic team — across hip replacement, Arthrosamid, ChondroFiller, PRP and the wider world of hip and groin pain.
SPAIRE hip replacement is a tendon-sparing posterior approach that preserves the piriformis and obturator internus, with published fracture data showing fewer dislocations and faster return to mobility than some comparators. For elective total hip replacement, evidence is less certain, and suitability depends on anatomy, deformity and surgeon experience.
Hip osteoarthritis usually brings gradually worsening stiffness and loss of walking or stair-climbing ability; femoroacetabular impingement causes front-of-hip or groin pain with bending and twisting; a labral tear more often clicks, catches or locks. Diagnosis depends on history, examination and imaging, not on symptoms alone.
Hip osteoarthritis injections are usually judged over months, not days: one high-dose hyaluronic acid injection offers the lowest-burden option, while a three-injection course can produce stronger pain and function gains, and steroid injections are generally repeated only every few months rather than weekly.
After hip replacement, home exercises are designed to restore gluteal and abductor strength, steady the pelvis, reduce limping and rebuild stair confidence; the exact precautions and progressions depend on the surgical approach, with posterior cases often limiting hip flexion, adduction and internal rotation for around six weeks.
Hip cartilage preservation works best for younger patients with a focal defect and a still-preserved joint space, where injections or grafting can delay replacement by years. Once cartilage loss is diffuse and osteoarthritis is advanced, hip replacement offers the more predictable result.
Ultrasound-guided hip injections are used for early-to-moderate osteoarthritis, diagnostic uncertainty and focal cartilage problems, with steroid giving the quickest short-term relief and PRP or other biologics aimed at longer symptom control. Accuracy is near-perfect under ultrasound, and steroid injections are usually avoided within three months of planned hip replacement.
Contained, full-thickness hip cartilage defects in younger adults are the main setting for preservation; moderate to severe osteoarthritis, especially Tönnis grade 2 or 3, usually points towards hip replacement. MRI helps distinguish a focal repairable lesion from diffuse wear, and rehabilitation comes before injections or surgery.
Hip arthroscopy can smooth unstable cartilage edges and treat focal damage inside the joint, but it does not regrow normal cartilage. It is most useful when symptoms, imaging and examination point to a local mechanical problem and the hip is not already dominated by advanced arthritis.
Desk-based work after hip replacement often becomes realistic from around 6 weeks, while jobs involving long standing, lifting, walking or climbing usually take longer, with many people returning within 12 weeks and some later. Recovery depends more on function, pain control and job demands than on a fixed date.
Lincolnshire Hip Clinic
Led by Professor Paul Lee
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