We frequently see patients whose hip implants have reached the end of their lifespan. Oftentimes these prosthetics were made at a time before the durable materials we now use were available. Through hip revision surgery, our surgeons replace these implants with new ones. Sometimes the implanted structures are sound and it is only necessary to replace the lining of the socket, making for a shorter surgery and quicker recovery.
This surgery is also necessary in some cases of joint infection, or if a replaced hip joint has loosened or pops out of joint recurrently, causing pain. If the joint is infected, the surgery takes place in two stages so the infection can be treated with antibiotics before the new implant.
Hip resurfacing, also known as a partial hip replacement, is sometimes the best choice for younger, active people who have degenerative or inflammatory arthritis of the hip, hip dysplasia or osteonecrosis. With many years of activity ahead of them and with younger, stronger bones that can more readily be resurfaced, this offers many who are under 65 a stable joint unlikely to dislocate, allowing for a fuller range of activity – including running, climbing and competitive sports.
In hip resurfacing, a few millimeters of the femoral head (ball) is shaved off, with a prosthetic surface affixed to the end to restore smooth movement within the acetabulum (socket). If the socket cartilage is badly damaged as well, it is similarly resurfaced and fitted with a prosthetic implant. The majority of our patients, however, only require the femoral head implant. An added benefit of hip resurfacing is that enough bone remains so that total hip replacement remains an option if needed down the road.
Minor imperfections in the hip joint may go unnoticed through an entire lifetime, but if your femur or socket are deformed (e.g., misshaped, too long or having protrusions) as with hip dysplasia or femoroacetabular impingement, surgery can offer relief from pain and restore mobility, preserving hips for a lifetime.
Our goal in the treatment of non-arthritic hip pain is to identify the source of the pain and treat the underlying cause (such as FAI or dysplasia). This approach maximizes our chances of a long-term successful outcome. We employ the latest techniques in hip preservation, including hip arthroscopy, periacetabular osteotomy, surgical hip dislocation, and femoral osteotomy.
Your hip pain may derive from bone spurs or joint mice that can be removed, or a cartilage tear that can be shaved smooth to balance the joint and relieve pain, all through minimally invasive arthroscopy. The surgeon makes a tiny incision and inserts an arthroscope for viewing the inside of the joint. Through a second incision, he or she inserts instruments for such tasks as shaving cartilage or bone, retrieving separated pieces impinging on the joint and suturing tissues.
Hip arthroscopy is typically an option for younger patients with a traumatic injury or a cartilage defect, rather than older patients with osteoarthritis or other degenerative conditions.
If you are diligent about frequent icing and the prescribed use of NSAIDS, and diligent with postoperative physical therapy, likelihood of a full recovery is very high. You should be back to normal activity within 4-6 months.
If you have hip dysplasia, your socket is not shaped or positioned properly to firmly hold the ball in place. In a periacetabular osteotomy, the surgeon carefully carves the pelvic bone around the joint area (ilium) and repositions it to better support. This is a very specialized procedure and we have one of only a handful of centers regionally employing periacetabular osteotomy combined with hip arthroscopy for a comprehensive approach to hip preservation. the ball of the femur. This surgery requires hardware to reconnect the pelvic bone.
If you are still having pain after a prior hip arthroscopy, you may have subtle residual deformity or other areas of impingement that may be best addressed with an open procedure. With this surgery, the surgeon carefully takes your hip out of the socket to gain complete access to visualizing the femur and acetabulum. This approach allows simultaneous complete correction of nearly all hip socket problems including labral replacement, cartilage restoration, capsule reconstruction, and femoral head complex deformities.
Some patients have hip pain that is caused by abnormal twisting or position of the femur bone. This abnormal position affects the way the feet turn while walking, and influence the position of the femur in the hip socket during motion and activities. Careful physical examination and imaging studies can help determine the significance of the abnormality and various techniques can be used to correct it.
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