Hip preservation specialists can repair joints without major surgery

Joint Health

by Baylor Scott & White Health

Jan 9, 2017

The hip is one of the hardest working joints in the human body, tasked with supporting the weight of our upper torso and giving us the ability to walk and move. So when things go wrong, the consequences can be serious.

The good news? Hip preservation specialists can treat hip injuries and disorders that can be debilitating to your day-to-day life, often without invasive surgery.

According to Hal Martin, DO, medical and research director of the Hip Preservation Center and orthopedic surgeon on the medical staff at Baylor University Medical Center, the goal is to offer patients an alternative to major hip surgery and its potential complications.

It’s called hip arthroscopy, a minimally invasive technique that can often repair internal tears and other hip problems.

“When we first started performing the procedure, we knew we could get people out of pain, but we didn’t know if we could actually prevent some of these total hip replacements,” Dr. Martin said. “Now we’re starting to see the data accumulate that shows it actually can not only prevent them, but also maintain a high level of function.”

Potential problems causing joint damage

The hip is a ball-and-socket joint that normally moves smoothly. But if the head of the femur (the ball) is shaped abnormally, the hip bones rub against each other and cause damage to the joint.

“One of the most common problems we see is cam impingement,” Dr. Martin said.

In cam impingement, the femoral head is not round and cannot rotate smoothly inside the acetabulum (the socket). A bump forms on the edge of the femoral head that grinds cartilage inside the socket.

“If the cartilage around the joint gets torn, you get more rapid degeneration that can lead to arthritis,” he said.

So, what causes the changes to the femoral head? A few factors include genetic predisposition and extreme activities such as high-impact sports.

Before hip arthroscopy was invented, physicians just waited until the hip failed and then performed a total hip replacement. But as with many surgeries, the procedure often came with complications.

A better fix: Minimally invasive surgery

In contrast, arthroscopy involves just three small incisions near the joint.

“We look for tears or debris inside the joint, as well as the cartilage and whether it’s torn,” Dr. Martin said. “If the formal head or cup doesn’t fit properly, we sculpt it so that it moves freely again.”

Dr. Martin notes that most patients are back to around 80 percent of full function after 12 weeks.

“They can continue to improve if they keep doing rehabilitation to strengthen the muscles and tendons,” he said. “We find that doing the procedure through the scope is the least invasive method with the best outcomes.”

Speak with a primary care physician or orthopedic specialist about a referral to a physician who specializes in hip preservation.

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