Our philosophy for hip pain: avoid surgery whenever possible, operate in a muscle-sparing way when needed.
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12-16 weeks of targeted rehabilitation led by a Hip Coach. Strength training, movement control and activity management.
EDA total hip replacement, arthroscopic labral repair or PAO for dysplasia. Always as minimally invasive as possible, with technique tailored to your condition.
An overview of the specific surgical procedures we perform, from minimally invasive arthroscopy to peri-acetabular osteotomy and hip replacement.
A total hip arthroplasty is a surgical procedure where the painful and stiff hip joint (osteoarthritis) is replaced by an implant. The goal of this surgery is to alleviate pain and improve mobility.
In a hip resurfacing arthroplasty (RSP), only the surface of the femoral head and the acetabulum is replaced, while your own femoral head and femoral neck are largely preserved. It is a bone-sparing alternative to total hip arthroplasty for selected, young and active patients and is therefore also called the 'sport hip'.
A hip arthroplasty consists of 4 components: an outer shell, an inner liner, a ball, and a stem. The components fixed in the bone (cup and stem) can loosen over time, which can cause pain in the hip or upper leg when bearing weight.
After a total hip arthroplasty, some patients may experience persistent groin pain. This can be caused by mechanical contact between the iliopsoas (hip flexor) muscle and the prosthetic cup. Previously, this would necessitate a revision of the cup. We now use a technique where the joint capsule is partially released and repositioned.
In cases of femoroacetabular impingement and/or a labral tear, an arthroscopy may be performed if conservative treatment and physical therapy do not provide sufficient improvement. Arthroscopy (keyhole surgery) is a surgical procedure in which the torn labrum is repaired and/or the impingement between the femoral head and acetabulum is removed.
A periacetabular osteotomy (PAO) is a surgical procedure for people with hip dysplasia.
The hip joint is encapsulated by the joint capsule. After surgery to the capsule (e.g., during arthroscopy), or after trauma, the capsule may be torn. Capsulorrhaphy is an operation where the joint capsule is sutured to anatomically repair the capsule.
A PLAC repair is an operation to repair a tear in the adductor muscles (PLAC lesion), which can also extend to the abdominal muscles. There are different types of PLAC injuries, depending on the extent of the tear in the adductor muscles and how far this tear extends into the abdomen.
In the event of a hamstring tear, hamstring repair surgery can be performed.
In cases of a rectus femoris tear (part of the quadriceps/thigh muscle), a rectus femoris re-insertion can be performed.
In the case of a gluteus medius tear (lateral buttock muscle, see image on the right), a gluteus medius re-insertion can be performed.
In cases of extensive gluteus medius tears (lateral hip muscle) and a denuded greater trochanter (side of the upper leg), a gluteus maximus transfer can be performed. This is sometimes observed in individuals who have undergone surgery on the side of the hip. The lateral hip muscles consequently diminish in volume, exposing the underlying bone of the upper leg.
After hip arthroplasty, mechanical impingement can sometimes occur between the pelvic rim and the greater trochanter (side of the upper leg). This surgery removes a small part of the greater trochanter so that there is no longer any mechanical impingement during deep hip flexion.
After hip arthroplasty, heterotopic ossification (HO) can sometimes occur. This is a calcification between the muscles. It causes pain and can lead to mechanical restriction during deep flexion movements of the hip.
If you have previously undergone surgery, osteosynthesis material, such as screws or a nail, may still be present. This could be after a PAO or a relative lengthening of the femoral neck, for example. Sometimes these screws or nail can cause discomfort. In such cases, the material can be removed.
In some patients, often after Legg-Calvé-Perthes disease, the outer part of the femur (the greater trochanter) is positioned too high relative to the femoral head. This results in the hip muscles having too small a lever arm, and the load on the hip joint is not optimal. A relative lengthening of the femoral neck restores the hip's biomechanics.
For a total hip replacement, the surgical approach makes a major difference for recovery and function. EHC applies the muscle-sparing EDA technique (Extended Direct Anterior) within the One-Day-Hip protocol.
| Aspect | EDA (muscle-sparing) | Classical approach |
|---|---|---|
| Access route | Between the muscles, without cutting through them. | Lateral or posterior, with detachment or incision of muscles. |
| Muscle damage | No cutting of gluteal muscles or hip abductors. | Muscles are detached or cut and need to heal. |
| Hospital stay | Often same-day discharge (One-Day-Hip). | Typically 2 to 4 days of hospitalisation. |
| Recovery time | Light activities within 2 weeks, sport build-up from 6 to 12 weeks. | Light activities after 4 to 6 weeks, sport only after 3 months or later. |
| Movement restrictions | No specific posture restrictions after recovery. | Temporary posture restrictions to prevent dislocation. |
| Dislocation risk | Low thanks to preserved muscle balance. | Slightly higher, especially in the first months. |
