For people with hip injuries, having no treatment options is a painful diagnosis. Patients of all ages with hip pain are frequently misdiagnosed with groin pulls or early arthritis. They can choose a hip replacement down the road, but synthetic hip replacements may prohibit an active or athletic lifestyle, and therefore may not be an option in young or middle-aged people. For athletes, hip injuries can be the equivalent of a pink slip for their careers.
For years orthopedic surgeons have been performing arthroscopy on shoulders and knees, while hip injuries have largely gone untreated. However, recent advances in technology and in the understanding of the hip joint have enabled surgeons to adapt arthroscopic techniques to repair injuries in the hip.
Living without pain
Benjamin Domb, MD, an orthopedic surgeon with Adventist Hinsdale Hospital, is one of a handful of surgeons pioneering a minimally invasive procedure that can give patients with hip injuries a new lease on life – hip arthroscopy. As one of Chicago’s leading experts in hip arthroscopy, Dr. Domb created and completed one of the first multi-center international fellowships in hip arthroscopy and joint preservation. He uses his expertise to treat patients from all over the country at Adventist Hinsdale Hospital in Western Chicagoland.
“With arthroscopic surgery, we can repair the injured structures of the hip and restore function,” says Dr. Domb. “We may also help, delay or prevent arthritis of the hip which can result from hip injuries.”
Minimally invasive treatments, maximum benefits
While performing hip arthroscopy, Dr. Domb creates two or three nicks in the skin that are about the width of a straw. From there, he inserts a camera, called an arthroscope, to see inside the hip joint and discover the source of the pain. He then uses a variety of instruments to shave, trim, cut, stitch or smooth the damaged areas.
Since arthroscopy is a minimally invasive procedure, patients experience minimal blood loss, pain and scarring. “Patients can go home the same day as the procedure and can quickly return to regular activities,” says Dr. Domb. With a hip replacement, patients must stay in the hospital and may take months to recover. Hip replacements also wear out after time and patients are usually unable to return to a high level of activity.
What is a torn hip?
Arthroscopy has been successful for treating many hip conditions. Some of the most common include:
- Labral tears – The labrum is a soft piece of cartilage that lines the rim of the hip socket, helping to support the joint. When a piece of the labrum tears, parts of the cartilage can become pinched, causing extreme pain. During hip arthroscopy, the torn part of the labrum is repaired by sewing it back to the rim.
- Hip impingement – Many patients are unaware of impingement until an injury, due to abnormally shaped bones inside their hip joints. The hip is a ball-and-socket joint, and one of the most common abnormalities – a ball that has a bump on it or is not quite round – can wear down the hip joint and cause arthritis. “A bump on the ball in a ball-and-socket joint is like a bump on a ball-bearing – it eventually wears everything down around it,” says Dr. Domb. Arthroscopically shaving down a bump or bone spur can help restore movement in the joint and may prevent further damage.
- Cartilage injuries – Cartilage is a smooth, hard material made out of collagen which coats the bones in our joints, allowing them to move easily. Because it has no direct blood supply, damaged cartilage may never heal and may continue to cause pain. Surgeons can now trim damaged cartilage arthroscopically.
- Loose bodies – Loose bodies are pieces of bone or cartilage floating within the hip joint that look like small marbles. Loose bodies can cause sudden, sharp pain in the hip. Removing loose bodies through arthroscopy can provide immediate pain relief for patients.
Helping athletes and non-athletes alike
Earlier this year, Arizona Cardinals quarterback Kurt Warner and New York Yankees third baseman Alex Rodriquez both underwent hip arthroscopy procedures. These high-profile cases helped bring much attention to this revolutionary procedure.
“Now we can help people of all ages and activity levels, from professional athletes to teenagers to homemakers,” Dr. Domb says. “Through hip arthroscopy, we can help patients who previously had no options.”