Hip Surgery – Procedures
Young and middle age adults suffer soft tissue traumatic injuries to the hip, which if treated in time with the right technique might prevent or delay the onset of arthritis that would otherwise require a full hip replacement. The commonest such injury is a torn labrum. The labrum is the cartilaginous rim or lip of the hip socket. When torn it causes disabling pain and clicking of the hip. The goal of arthroscopic and mini-open surgery is to repair or trim the damaged labrum and shave any bony spurs or bumps that have built up and threaten to cause irreversible degenerative arthritis. Dr. Meere is a member of the Joint Preservation Center, where leading research is conducted in this pioneering field.
Hip fractures are very common. The treatment varies depending on several factors such as age, bone quality, severity of the injury, and anticipated level of function. Though we are prepared and able to cover the range of treatment options, our philosophy is to allow for a biological preservation whenever feasible. If the natural joint has a reasonable chance of healing satisfactorily this should be the first option. Dr. Meere works closely with the Osteoporosis Center to assist in prevention of future fractures through medical management and physiotherapy.
A hip resurfacing arthroplasty or replacement consists of a spherical metal cap fitted onto the existing “head” of the bone, after trimming of the worn or damaged cartilage cap. It is thus similar to a dental crown. Contrary to a hip replacement, the neck part of the bone is preserved. On the socket side, the liner-less polished metallic socket is fitted in the natural bone cavity after cartilage rasping. Hip resurfacing arthroplasty is particularly well suited for younger, very active patients since it allows a natural range of motion while permitting full loading and more vigorous activities. Furthermore, by preserving the femoral neck bone stock, it facilitates any subsequent conversion to a standard hip replacement (if ever necessary). The technique, however, requires a more aggressive dissection and does not allow for a minimally invasive surgical approach.
The resurfacing of the hip falls under the category of Metal-on-Metal hip implants. There has been much controversy about this class of implant in the last years, based on the potential toxic and damaging effects of metallosis or allergic rejection of metallic wear particles. Though the majority of patients are best suited with a hip replacement rather than a resurfacing, the latter remains a potential option for younger large frame males intent on vigorous contact or loading physical activity. For further information on this, please contact your physician or link to the websites below.
Click here to read more on hip replacement at Nytimes.com
With advancing years or mechanical damage from a sports injury or accident, the ball and socket hip joint can develop arthritis, defined as the erosion of the cartilage buffer zone between the bones forming the articulating joint. When the pain, stiffness and loss of mobility are no longer tolerable, the patient becomes a candidate for a hip replacement. In this routine procedure, the worn out femoral ball (aka head) is replaced by a metal or ceramic smaller ball set on a titanium stem, which is inserted into the shaft of the thigh bone (femur). This articulates with a liner set into a half-dome titanium shell, embedded into the pelvic socket. The clinical and patient satisfaction success rate of the operation is one of the highest of all surgical procedures, making it a favorite amongst patients and surgeons alike.
Dr. Meere specializes in various hip surgical techniques commonly known as “minimally invasive surgery” (MIS). This term refers to the type of surgical approach or incision made. It is the exposure of choice for primary or initial hip replacements. Direct anterior and SuperPATH techniques are examples where the key posterior muscle groups are left intact, minimizing the risk of dislocation and optimizing the functionality for a faster and easier recovery. However, not all patients are candidates. It is the physician’s responsibility to judiciously select the best approach for each individual case.