Consultation
The consultation with a hip specialist surgeon is a crucial step that begins with a general presentation of the patient: age, profession, height, and weight.
Risk factors for coxopathy are noted: family history of prostheses, childhood hip pathology, hip trauma, high-risk sports (team sports, combat sports, dance, etc.), and hip malformation. The patient then describes the history of their problems and any treatments they have already undergone.
Imaging and any surgical reports should be brought to the consultation.
A Tailored Consultation for a Hip Prosthesis
The in-person consultation includes a complete physical examination. The surgeon assesses the fluidity of the patient’s gait and the stability of single-leg support. The lumbopelvic-femoral statics are evaluated (pelvic tilt, leg length discrepancy, scoliosis). On the examination table, an analysis of mobility, muscle testing, and the search for pain during coxopathy tests are conducted. A basic neurological examination is performed, along with palpation of pulses and the search for parietal hernia.
The consultation continues with the analysis of imaging results: simple radiographs, Dunn’s profile for femoral cam investigation. Ultrasound provides additional elements regarding joint effusion and possible tendinomuscular pathologies. Cross-sectional imaging is sometimes necessary to refine the diagnosis (MRI, CT scan).
Follow-up After a Hip Prosthesis Consultation
After the consultation, additional examinations might be prescribed: MRI or arthro-CT with infiltration for hip impingement, 3D CT scan following the Symbios protocol for planning a custom-made prosthesis, or analyzing a problematic prosthesis.
Proposed Treatments
The proposed treatments are ranked by their level of invasiveness: physical therapy, foot orthoses, anti-inflammatories, infiltration, viscosupplementation, PRP, arthroscopy or conservative surgery, prosthesis or prosthesis revision. If surgery is suggested, the consultation should provide clear, comprehensive, and tailored information for each situation.
