The hip joint is a simple ball-in-socket structure. The ball-shaped femoral head rotates inside a cup-shaped socket called the acetabulum. Usually this joint works smoothly, with little friction or wear. The well-fitting surfaces of the femoral head and acetabulum which face each other are each lined with a layer of articular cartilage and are lubricated by a thin film of synovial fluid which reduces friction inside the normal hip to less than one tenth that of an ice cube gliding on ice. The labrum is a rim of fibrous cartilage which lines the outer edge of the acetabulum and serves to stabilise and cushion the hip joint.
Over the past ten years, our understanding of hip problems has rapidly advanced. Many young, active patients with hip pain were previously thought to not have treatable problems, and hip arthritis in young adults was previously thought to be due to bad luck or unfortunate genetics. We now know that hip pain can indicate underlying conditions and subtle structural abnormalities that are not only causing symptoms now, but can also cause hip arthritis.
Alongside the recent advancements in understanding of hip problems have come advanced surgical techniques which have dramatically improved our ability to treat these problems. Hip arthroscopy is a relatively new technique that allows hip problems such as impingement, labral tears and loose bodies to be effectively treated with minimally invasive techniques.
Hip dysplasia is a condition where the acetabulum (hip socket) is too shallow. This is often present from birth, however may not cause any symptoms until adolescence or early adulthood. The shallow acetabulum can cause hip pain, labral tears, and early hip arthritis.
Fortunately, hip dysplasia in adolescents and young adults can be effectively treated with a special operation called a Bernese Periactabular Osteotomy (PAO), otherwise known as a Ganz Periacetabular Osteotomy, which improves pain and prevents early arthritis in patients with hip dysplasia. This operation is technically challenging, however Dr. Boyle has undertaken extensive training in this procedure by international experts at Harvard University in the USA. Dr. Boyle has personally performed over 80 Bernese PAOs, and is the most highly-trained surgeon in New Zealand in this field.