Hip surgery
My work in hip surgery focuses on hip replacement and on the assessment and treatment of symptoms following hip replacement. Treatment begins with a careful assessment of the patient’s symptoms, clinical findings and imaging.
Hip pain does not necessarily originate in the hip joint itself. Disorders affecting the surrounding tendons and muscles or the lumbar spine can cause similar symptoms and are therefore considered as part of the assessment.
For advanced osteoarthritis of the hip, total hip replacement may be appropriate when symptoms and functional limitations can no longer be adequately managed with nonsurgical treatment.
Preoperative planning considers the individual anatomy of the hip and bone quality, as well as restoration of the natural joint geometry. The choice, positioning and method of implant fixation, together with the bearing surface and femoral head, are tailored to the patient’s anatomical and functional requirements. Precise surgical execution while preserving the soft tissues is essential.
My training in hip replacement encompassed a range of surgical approaches. I have used the direct anterior approach (DAA) for primary hip replacement since 2008.
The hip joint is reached through a natural interval between muscle groups, without detaching the muscles important for hip function from the bone. This permits soft-tissue-preserving implantation and may contribute to faster functional recovery, particularly during the early phase after surgery.
I am also familiar with the posterior approach, allowing the surgical approach to be adapted to the individual situation when needed.
Symptoms or functional limitations may persist or arise following hip replacement. The first priority is a careful analysis of the underlying causes. Particular attention is paid to the position and fixation of the prosthesis. Deviations can affect stability, soft-tissue tension and muscle function and may cause symptoms.
Damage to muscles and tendons may also play a role. Potential sources of pain outside the hip joint, such as the lumbar spine, must also be considered. If clinically suspected, infection of the prosthesis must be excluded.
The aim is to identify the cause of the symptoms as precisely as possible and treat it in a targeted manner. If surgical correction is necessary, individual or all prosthetic components may need to be replaced, depending on the findings.