Hip

 

Aims of the Hip Pathway:

  • To improve patient access earlier in their treatment pathway to options and alternatives to surgery as well as on likely outcomes 
  • To ensure patients who require surgery are appropriately referred and given preoperative care
  • To allow patients to fully participate in decisions about their care
  • To offer better pre-operative preparation through physiotherapy which helps patients to better manage their condition and/or prepare for surgery as well as reducing post-operative recovery times and improving post operative outcomes
  • To ensure that the patients who are referred into secondary care are suitable and ready for surgery and properly prepared so as to enjoy the best possible outcomes 
  • To ensure more joined up holistic working between primary care , physiotherapy services and secondary care 

Quick Note: 

Please note that this service is for patients surgical and non surgical management of hip pain

Management options are discussed with the patient at their initial assessment and should surgery be required they will be referred immediately to their chosen secondary care location. They will also receive pre-operative preparation whilst awaiting their hospital appointment to ensure that by the times they see the orthopaedic consultant they are fully prepared for surgery.

All of the assessments are undertaken by our senior physiotherapists who have specific training and and are able to assess and diagnosis hip pathologies and refer on appropriately.

Management in primary Care:

Initial management strategies for patients with osteoarthritis of the hip include:

  • Reassurance and patient education
  • Weight reduction in patients who are obese (BMI>35). These patients should be referred to their local weight management service
  • Support and referral for smoking cessation
  • Advice about appropriate walking aids 
  • Patient specific exercise programmes
  • Advice on cushioned/supportive footwear
  • Advice on medication which should typically include analgesics and non steroidal anti-inflammatories 

How to access the service:

Response times & Prioritisation:

All hip patients referred into this service will be seen and assessed by a senior Physiotherapists within 4 weeks of us receiving a referral 

Program stage 1 – Conservative Management:

This is for patients with moderate or established osteoarthritis who require conservative management

The patient will either be seen as a 1:1 or 5, 1.5 hour group sessions which will cover the following:

  • General fitness and flexibility
  • Strength and mobility exercises (as supported by the NICE guidelines)
  • Weight loss and dietary advice
  • Pain control and management
  • Smoking cessation
  • Discussion and video footage with expert patient 
  • Discussion re equipment and walking aids if required

Programme Stage 2 – Preparation for Surgery:

  • The focus of stage 2 is to discuss surgery and refer the patient to their chosen secondary care location
  • They will receive an initial assessment within 4 weeks of us receiving the referral 
  • The GP will be informed of what is happening and receive a copy of the orthopaedic referral and where it has been sent 

Patient Pathway Booklet

 TitleOwnerCategoryModified DateSize 
OA Pathway BookletFrancesca Wythe 22/01/20181.69 MBDownload

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