Guided Hip Injections

A guided hip injection involves injecting a small quantity of local anaesthetic and anti-inflammatory steroid into your hip joint.  The procedure is performed in the operating theatre using an X-ray machine to guide the needle.

The hip joint is a common source of pain experienced in the groin and thigh, or even around the knee.  More common causes for the pain include:

  • osteoarthritis (wear and tear)
  • synovitis (inflammation in the lining of the joint) 
  • abnormalities of the hip labrum (specialised supporting rim of the hip joint)

Occasionally problems in other areas, particularly the lower spine, sacroiliac joint, pubic bone joint or the knee can produce very similar pains.

An injection into the hip joint can be used to aid diagnosis and to differentiate between pain of hip origin and pain arising from elsewhere.  The injection can give significant symptomatic relief, particularly in early arthritis or minor tears of the hip labrum.

On the day of your injection you can eat and drink as normal and you should take all prescribed medication unless your consultant states otherwise.

We advise that you arrange for a family member or friend to accompany you as you will not be able to drive yourself home and shouldn’t take public transport alone.

When you arrive at St Joseph’s you will be assessed by a nurse and your consultant.

The spinal anaesthesia involves injecting a small amount of anaesthetic into the fluid surrounding the spinal cord in the lower back.  This induces a numbness in your lower limbs which allows the operation to take place without pain.  Feeling will return to your legs a few hours after the completion of the operation.

The hip injection is performed in the operating theatre under a local anaesthetic and usually takes approximately ten minutes.

You will be lying on your back for the procedure.  The skin over the hip is cleaned with antiseptic and local anaesthetic is injected, inducing a numbness in your lower limbs which allows the operation to take place without pain.  Feeling will return to your legs a few hours after the completion of the operation.

A needle is then passed into your hip joint under the guidance of an x-ray machine.  A small amount of dye is injected to confirm the correct position of the needle.  The hip is then injected with anaesthetic and an anti-inflammatory steroid.  A small dressing will be applied to the injection site.

You will remain in the hospital for at least thirty minutes after the procedure.  Provided there is no evidence of any allergies, leg problems or weakness you will then be allowed home.

You must not drive yourself home or go home alone on public transport.  We advise that you arrange for a family member or friend to accompany you as you will not be able to drive yourself home and shouldn’t take public transport alone.

You should avoid excessive exercise or heavy work for the first few days.  The dressing can be removed the day after your injection and you should continue to take pain killers as advised by your consultant.

Diabetic patients should closely monitor their blood sugar measurements over the first few days.

A follow-up appointment with your surgeon is usually arranged for approximately six weeks after your injection.  You should monitor any improvement in your symptoms.  We recommend keeping a diary of changes to discuss with your surgeon at your follow-up.

These are all very rare, however possible risks and side effects include:

  • infection
  • thigh numbness and/or weakness to the leg.  This is usually temporary and due to the local anaesthetic injection affecting the nerves supplying the skin and muscles of your thigh
  • bruising at the injection site
  • allergy to the injected medication
  • skin discolouration at the injection site

If you are a diabetic and take insulin, it is important to monitor your blood glucose closely for the first few days after the injection as the injected steroid may temporarily increase your sugar levels.

If the hip joint is the source of your symptoms, you may notice an improvement within 15 -30 minutes as the local anaesthetic numbs the joint.

The steroid part of the injection usually takes several days to work.  Your symptoms may occasionally become worse for 24-48 hours after the injection, before the steroid starts to work.

This is very variable and differs greatly between patients.  Occasionally the pain returns within a few days, more commonly the injection will give benefit for several weeks or even months.

Further treatment options will be discussed with your surgeon at your follow-up appointment.

Consultants

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