Hip Resurfacing at Surface Hippy

Category: Hip Treatments

Alternative treatments for hip problems.

  • New Procedure Helps Patients Avoid Hip Replacement and Repairs Joint Damage

    December 18, 2017


    COLUMBUS, Ohio – Doctors at The Ohio State University Wexner Medical Center are using a procedure called Subchondroplasty to give patients with damaged hips more treatment options and ultimately avoid replacement surgery.

    “We want to preserve the native hip whenever possible because once you have a hip replacement, there’s no going back,” said Dr. Kelton Vasileff, an orthopedic surgeon at Ohio State Wexner Medical Center. “We’re able to use a bone-hardening procedure that’s traditionally been used in knee surgery to help repair a patient’s own hip joint.”

    During the procedure, a bone substitute material is injected into a small hole in the joint, filling any voids or lesions in the bone. Over the few years following surgery, a patient’s body replaces the bone-hardening material with their own healthy bone, leading to what Vasileff hopes are permanent repairs.

    “In the past, a replacement would be the only long-term option for a lot of patients, but this procedure allows me to add support to the bone, making more damage-reversing surgeries possible,” said Vasileff, who specializes in hip preservation surgery.

    Each year, more than 300,000 Americans receive a hip replacement. It’s a major surgery that requires months of physical rehabilitation, and there’s no guarantee the implant will last forever, especially in younger patients. But doctors at The Ohio State Wexner Medical Center are giving patients new options that allow them to repair their damaged hip and avoid replacement surgery. “We want to preserve the native hip whenever possible because once you have a hip replacement, there’s no going back,” said Dr. Kelton Vasileff, an orthopaedic surgeon at The Ohio State Wexner Medical Center. “We’re able to use a bone-hardening procedure that’s traditionally been used in knee surgery to help repair a patient’s own hip joint.” The procedure is called Subchondroplasty, in which a bone substitute material is injected into the joint, filling any voids or lesions. Dr. Vasileff uses it in conjunction with other treatments to help patients avoid replacement surgery. “In the past, a replacement would be the only long-term option for a lot of patients, but Subchondroplasty allows me to add support to the bone, making more damage-reversing surgeries possible,” he said. Over the few years following surgery, a patient’s body replaces the bone-hardening material with their own bone, leading to what Dr. Vasileff hopes are permanent repairs. The procedure is also much less invasive than a total hip replacement, allowing patients to get back on their feet sooner.

  • PRP Platelet-Rich Plasma Treatment for Injured Tendons, Muscles and Joints by Dr. Brian C. Halpern

    Published on Mar 12, 2012

    Dr. Brian C. Halpern, Sports Medicine Physician at Hospital for Special Surgery, discusses how platelet-rich plasma (PRP) injections may help treat injured bone or soft tissue, such as a tendon or ligament. Produced from a person’s own blood, PRP is a concentration of a type of cells called platelets which contain factors that are essential for healing tissues. PRP has been shown to help improve function in people with conditions such as chronic tendonitis, arthritis, tennis elbow, golfer elbow, rotator cuff tears and Achilles tendon injuries.

    The PRP treatment process starts with a blood sample that is taken from a patient. The blood is put into a centrifuge to separate the PRP from the blood. After the PRP is treated, it is injected back into the patient’s injured area of bone or soft tissue. Some patients who received a PRP injection experienced improved function and less pain within two to six weeks following treatment. Because PRP is created from a patient’s own blood, it is considered a relatively low-risk treatment with the potential to improve or speed healing. Further studies are needed to prove the effectiveness of PRP treatment.

  • Stem Cell Therapy for Osteoarthritis of the Hip: Current Perspectives by Nathan Wei, MD

    The most common form of arthritis is osteoarthritis.
    Osteoarthritis is caused by the premature wearing
    away of cartilage, the gristle that caps the ends of
    long bones.Osteoarthritis has a predilection for
    weight-bearing joints such as the neck, low back,
    hips, and knees.One of the areas that has gained a lot of
    interest in recent years because of its apparent
    increased incidence and prevalence, is
    osteoarthritis of the hip. Unlike osteoarthritis of
    the knee, there is very little correlation with
    obesity as far as the initiation of disease.
    However, once osteoarthritis has developed,
    worsening of symptoms occurs with increasing
    adiposity.

    There is also a correlation with prior trauma to
    the hip as well as the presence of congenital
    abnormalities that may predispose the hip to early
    deterioration.

    Among these include a history of Legg-Calve-Perthes
    disease, hip dysplasia, and prior fracture.

    That being said, with the growing number of Baby
    Boomers, particularly active Baby Boomers,
    osteoarthritis of the hip is a significant
    contributor to activity restriction.

    The hip is a ball and socket joint. The ball is
    the head of the femur and the socket is the
    acetabulum of the pelvis. Both the acetabulum as
    well as the head of the femur are covered with a
    layer of hyaline cartilage. The hip is constructed
    such that multiple ligaments and muscles provide
    stability for the joint.

    Unfortunately, the peculiar angulation of the hip
    contributes to steady worsening of osteoarthritis
    once abnormal forces come into play and cartilage
    begins to wear.

    The progression of osteoarthritis often leads to
    the formation of bony spurs called osteophytes.
    These osteophytes may eventually cause what is
    termed “femoroacetabular impingement” or FAI.

    These osteophytes develop in two distinct
    locations: either at the outside rim of the
    acetabulum or at the junction between the ball and
    neck of the femur. When spurs develop on the
    acetabulum and cause pinching with hip movement this
    is called a “pincer” deformity. When the spurs on
    the femoral head/ neck cause pinching, this is
    called a “CAM” deformity.

    Symptoms of osteoarthritis of the hip include
    pain in the groin and/or buttock that is aggravated
    by internal rotation of the hip such as occurs with
    walking. Pain may also radiate down the front of the
    thigh to the knee. As pain progresses, nighttime
    discomfort becomes an issue. Shortly thereafter,
    restriction of range of motion develops.

    Treatment, to date, has been primarily
    symptomatic including analgesic and
    non-steroidal-anti-inflammatory drugs,
    glucocorticoid injections, massage, chiropractic,
    and physical therapy.

    Surgical remedies have included osteotomy (where
    a wedge of bone is removed to line the joint up
    better), resurfacing (a modified replacement), and
    total joint replacement. While surgical treatments
    are by and large effective, they are irreversible
    and they do carry attendant risks, some
    life-threatening.

    So the search has been to develop treatments that
    will be effective but also preserve the joint. One
    such approach is the use of autologous stem cells.
    In our hands, the procedure which involves the use
    of autologous stem cells (a patient’s own stem
    cells) along with autologous fat, and growth factors
    has been relatively successful. [At the same time,
    osteophytes are trimmed using a special fenestration
    technique.]

    Quite frankly, so far, our hip results have not
    been as good as with the knee. There may be a number
    of factors involved including patient selection, the
    difference in joint mechanics, the fact that the
    iliopsoas bursa- a large cushioned sack- sits in
    front of the joint and stem cells may dump out into
    the bursa rather than staying in the joint,
    inability to go at complete non weight-bearing after
    the procedure, and so on.

    We are continuing to modify our approach to this
    technique and our patient results are now beginning
    to approach what we initially hoped.

    Nonetheless, the procedure needs to undergo
    constant improvement to eventually achieve the
    results we want and the patient deserves.

    Nathan Wei, MD, FACP, FACR is a rheumatologist and
    Director of the Arthritis Treatment Center

    . For
    more info: Arthritis Treatment [http://www.arthritis-treatment-and-relief.com/arthritis-treatment.html]

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