Orthopaedic Surgeons of the Hip

Mr Robert Howells is the Hip specialist at Park Clinic Orthopaedics in East Melbourne.

For information about specific Hip conditions and surgeries, please click on the list below.

Hip Conditions and Hip Surgeries

Osteoarthritis of the Hip

Osteoarthritis of the hip, like all forms of arthritis, is due to a loss of the cushioning joint surface tissue (articular cartilage) that covers the ends of the bones of the joint – the femoral head (ball) and the acetabulum of the pelvis (socket). This is a progressive condition and the natural history is one of slow deterioration – as the articular cartilage loss increases, so usually do the symptoms. When the articular cartilage layers are worn away completely, the joint articulates with “bone on bone” surfaces – this is usually very painful (as the bone has lots of nerve endings) and constitutes an advanced osteoarthritis.

Inflammatory Arthritis of the Hip

Inflammatory Arthritis of the hip, like all forms of arthritis, is due to a loss of the cushioning joint surface tissue (articular cartilage) that covers the ends of the bones of the joint – the femoral head (ball) and the acetabulum of the pelvis (socket). The end result is progressive loss of articular cartilage, ultimately leading to a “bone on bone” arthritis situation.

Arthroscopy of the Hip

Hip Arthroscopy is a minimally invasive operative procedure which allows the treatment of a range of hip joint conditions. It can be used to treat labral (hip cartilage) tears, local areas of joint surface damage, remove loose bodies and undertake simple treatment of early arthritis conditions.

Avascular Necrosis of the Femoral Head

Avascular Necrosis (AVN) of the hip occurs when the blood supply to the bone of the femoral head (the ball part of the hip joint) is disrupted. This typically leads to death of the bone cells (osteocytes) in a localized area of the top of the femoral head/ball leading to collapse of the affected bone and its associated joint surface. This irreversible damage generally leads to a progressive arthritis (often quite rapid) of the hip with pain, stiffness and loss of function for walking, bending etc.

Trochanteric Pain Syndrome

Trochanteric Pain Syndrome (TPS) refers to conditions that lead to pain over the greater trochanter of the upper femur (thigh bone) – this is the bony prominence on the outside of the hip. Most commonly this involves inflammation of one of the bursae (bursitis) of the hip but other tissues in the area can be affected.

Loose Body of the Hip

The hip, like any other joint in the body, can be affected by loose bodies. These loose bodies may be cartilaginous or bony, but are most often a combination of both – these are referred to as osteochondral (osteo = a bony core and chondral = a cartilage surface) loose bodies.

Loose bodies can vary in size from tiny to very large and their size tends to dictate what kinds of problems they can cause. Symptomatic loose bodies can be removed by open operation (for very large loose bodies) or by arthroscopic (minimally invasive) means in most cases.

FemoroAcetabular Impingement (FAI)

FemoroAcetabular Impingement refers to a condition of the hip where there is abnormal contact (impingement = pinching or conflict) between the ball of the hip (femoral head) and the edge of the socket (acetabulum).

Snapping Hip

Snapping Hip Syndrome is characterized by an audible and sometimes visible “snapping” or “cracking” sensation of the hip that generally occurs when the leg is moved in a certain way.

The most common reason for snapping hip is movement of the fascia of the outside of the leg (the fascia lata/iliotibial band complex, which extends from the side of the pelvis to the outside of the knee) over the bony prominence on the outside of the hip (known as the greater trochanter).

Meralgia Paraesthetica

Meralgia Paraesthetica (MP) is an unusual condition that is characterized by a burning pain and sensory abnormalities (tingling and/or numbness) affecting the outer side of the thigh.

It is caused by pressure on/compression of a nerve – the lateral cutaneous nerve of the thigh (LCNT)(also known as the lateral femoral cutaneous nerve) – as it crosses from the lower abdomen into the upper thigh.

Stress Fracture of the Hip

Stress fracture of the hip is an unusual condition that generally occurs in athletic individuals who begin or significantly increase running/other impact activity. The fracture itself usually occurs in the femoral neck at the base of the ball of the hip joint. A stress fracture begins as a tiny microscopic crack in the bone which slowly increases in size with loading activity such as running.

Contact Park Clinic Orthopaedics in East Melbourne

Please contact Mr Robert Howells’ rooms on (03) 9419 2811 if you require further information.