What Are the Treatment Options?
The treatment options for management hip disorders such as excruciating hip pain and hip dysfunction, in young patients, have been limited. However, the newer minimally invasive techniques have been found to be beneficial in these patients and these also avoid the need of hip replacement. Some of the common hip preservation surgical procedures include peri-acetabular osteotomy, proximal femoral osteotomy, open hip debridement, hip arthroscopy and cartilage restoration procedures
Hip arthroscopy is an excellent surgery that has helped many patients restore their hip function and alleviate pain originating from their hip. Hip arthroscopy is a minimally invasive surgery that is performed through very small incisions to evaluate and treat a variety of painful hip conditions. An arthroscope is a pencil-sized instrument that has a small lens and lighting system at its one end. The arthroscope magnifies and illuminates the structures inside the body with the light that is transmitted through fiber optics. It is attached to a television camera and the internal structures are seen on the television monitor.
"Hip Preservation Surgery." Harish S. Hosalkar, MD. drhosalkar.com, n.d. Web.
Dennis Hamblin, 53, enjoys the adrenaline rush of hitting the slopes on his skis and has always lived an active life since he was on his high school’s track team. After track practice, Dennis often joined friends in pickup football games and it was during one of these pickup games that he initially injured his groin. Over the next several years, Dennis dealt with the groin pain from the injury he sustained his sophomore year in high school. With youth on his side, Dennis found that by skipping key stretches he was able to manage the pain and went on to a successful career as a distance running competitor at the collegiate level. However, improperly addressing his true injury took a toll on his body.
“I had many lower back issues and issues with restricted range of motion. I always assumed this was because I didn’t like stretching and ran about 120 miles per week when I was competing.”
After college, Dennis ran less but the pain remained. “I just assumed I had initially torn my groin and the pain was due to scar tissue,” Dennis says. The pain eventually became unbearable when he re-aggravated his injury during a skiing trip two years ago.
“My pain became much worse after this so that even doing odd jobs around the house would make me hurt all night. The two months or so right before surgery I really didn’t feel like doing much of anything since the pain was fairly constant by then.”
Dennis visited a friend who was a hip specialist because his groin pain would sometime radiate into the hip. The specialist confirmed that Dennis was suffering from femoral-acetabular impingement (FAI) with a likely labral tear. The doctor referred him to Tri-City Medical Center’s Dr. Harish Hosalkar, who specializes in hip preservation surgeries. The goal was to try hip preservation and avoid total joint at this stage because of Dennis’ young age.
Dr. Hosalkar performed a full hip preservation surgery with open safe surgical dislocation on Dennis’ right hip and also repaired cartilage damage. The procedure was quick and Dennis was able to recover in the comfort of his own home. “I had my surgery on a Wednesday morning and was discharged on Friday around 1 p.m.,” says Dennis.
The recovery timeline for hip preservation surgery is much quicker than total joint replacement. “For large tears requiring an open surgery, most patients will still be able to get back to their regular physical activities with no restrictions within 10–12 weeks,” says Dr. Hosalkar. “Arthroscopic surgery has even quicker healing time.” For Dennis, he was driving 17 days after his operation, back to working full time within four weeks and skiing after just 11.5 weeks. “I was in Utah skiing and that wasn’t just on the groomers,” says Dennis. “I skied the bumps and the steep as well. My hip felt just fine.”
Dennis is excited that he was able to return to his active lifestyle so quickly and has inspired others who are facing the possibility of hip surgery and worried about the possible impact on their active lifestyles. “I joined a Facebook page where people who have had this procedure would post their experiences,” Dennis remembers. “When I posted [my story], a couple of men who were facing this procedure thanked me for giving them some hope.”
Now that Dennis is free of pain for the first time in decades, he’s ready to tackle activities he couldn’t do before and even pick up some old hobbies he’d given up. “I am thinking about trying surfing this summer. My son is a surfer,” Dennis conveys excitedly. “I am interested to see about swinging a golf club since I had issues being able to rotate through my hips prior to surgery. I have a list of home projects to accomplish.”
Ten or 20 years after earning a place on the all-star, varsity and college teams, many former or lifelong athletes like Dennis are now suffering pain and restricted motion in their knees. Luckily for these patients in their 30s, 40s, and 50s, new surgical approaches allow them to preserve their natural hip joints and avoid or delay a total joint replacement for several more decades. Best of all, these new approaches get patients like Dennis back on their feet faster so they can return to what they love doing.
To learn more please call 760-940-3000 or visit our Orthopaedic & Spine Institute web page.