COLUMBIA, Mo. - In 2012, Amanda Sobczak's family doctor referred her to Ajay Aggarwal, M.D., an orthopaedic surgeon at the Missouri Orthopaedic Institute. Sobczak had begun experiencing pain in her hips a year earlier. Physical therapy helped relieve the pain in her left hip, but the pain in her right hip was persistent and worsening over time.
"I have a congenital problem with the shape of my hip joints that was causing the pain," Sobczak said. "Dr. Aggarwal was very, very nice. He was very good at explaining what was going on with my hip."
To repair the problem, Aggarwal performed minimally invasive joint-preservation surgery on her right hip, reshaping the joint and repairing damage to her labrum, the lining inside the hip joint. After the outpatient procedure, Sobczak walked on crutches for two weeks and underwent physical therapy three times a week for six weeks.
"I like to be really active, and it wasn't very long at all before I was back at the gym working out, riding horses and running," Sobczak said. "My right hip is doing fine, but now my left hip is bothering me, so I'm planning to have Dr. Aggarwal do surgery on that side, too."
Problems with the hip joint are common. According to the U.S. Centers for Disease Control and Prevention, there are more than 330,000 total hip replacement procedures performed in the United States every year. However, for many people, such as younger patients like 25-year-old Sobczak, joint repair and preservation of their natural joint is a better treatment than replacement.
"Joint preservation is a very good option for patients who have pain caused by underlying developmental joint problems," Aggarwal said. "In addition to causing pain, these joints also are predisposed to developing degenerative disease. Joint preservation aims to restore a patient's natural joint, relieving their pain and delaying the onset of joint degeneration."
Artificial hip joints have a limited lifespan of ten to 15 years, so most patients aren't considered candidates for total hip replacement before age 50. However, surgeons at the Missouri Orthopaedic Institute typically perform joint preservation surgery on patients between 12 and 55 years old.
"Because it maintains a patient's natural joint, hip preservation patients usually maintain full range of motion and strength in their joints, compared to hip replacement patients who often regain mobility but lose some function compared to their original joints," Aggarwal said. "Hip preservation has a shorter recovery period, as well. Patients undergoing open surgery usually are able to walk again within two to three weeks and return to all their regular activities within three months of physical therapy, and it can be even shorter for minimally invasive surgery. That compares to six months of recovery time for hip replacement."
Aggarwal and his colleague Brett Crist, M.D., another orthopaedic surgeon at the Missouri Orthopaedic Institute, provide a comprehensive approach to hip-preservation surgeries. While some severe hip deformities and injuries require open surgery to repair, others can be performed with minimally invasive techniques, such as arthroscopy. The treatment options they provide include:
- Periacetabular osteotomy - reshaping the socket of the hip joint to better fit the ball of the joint at the top of the femur bone
- Hip arthroscopy - a minimally invasive technique used to repair mild to moderate injuries and abnormalities, such as removing bone burrs inside the joint or repairing the labrum inside the socket of the hip joint
- Mini-arthrotomy - a technique for repairing damaged or deformed joints through a small surgical opening
- Surgical hip dislocation - an open surgical technique for repairing more-severe injuries, such as those requiring microfracture of damaged cartilage, or joint deformities, such as joint sockets that are too deep
For more information about hip preservation surgery or to make an appointment, please contact the Missouri Orthopaedic Institute at (573) 882-BONE (2663).