HIP PRESERVATION OFFERS HOPE FOR A RETURN TO AN ACTIVE LIFESTYLE
Research indicates that early intervention for hip issues may slow their
progression. Hip preservation is a type of intervention for young, active
adults that can improve the structure and function of the hip joint.
With his unique background as a board-certified, dual-fellowship trained
orthopedic surgeon, specializing in both hip and sports medicine surgery—and
as a US Ski & Snowboard Sports Medicine Physician—orthopedic surgeon
Austin W. Chen, MD of BoulderCentre for Orthopedics described the latest hip preserving treatments
for non-arthritic conditions during a free online health lecture.
What is Hip Preservation?
“Hip preservation is based on the idea that some common hip problems,
when identified early, can be addressed to improve the mechanics of the
hip joint,” said Dr. Chen. Hip preservation can be particularly
helpful for young athletes and active adults whose activities involve
extreme hip motions such as running, cycling, golf, hockey, gymnastics,
dancing, basketball or soccer.
Treatments associated with hip preservation include:
- Activity modification
- Physical therapy
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Hip arthroscopy
Watch Dr. Chen's online lecture on "Improving Painful Hip Conditions."
Conditions That Can Benefit From Hip Preservation
Femoroacetabular Impingement (FAI) - more simply known as hip impingement, is a condition that can lead to
labral damage, hip pain and instability. “The first sign of FAI
often is pain in the groin, on the outside of the hip or in the buttocks.
Patients may feel a tightness and a loss in range of motion. With high
flexion or rotation, they may also feel a pinching,” said Dr. Chen.
Hip labral tears - an injury to labrum. It can be caused by trauma, structural or degenerative
issues. Symptoms include pain or stiffness. It can be treated non-surgically,
or with surgery in severe cases.
Snapping hip - a condition characterized by a snapping sensation and often a popping
noise that occurs when the hip is flexed and extended. In some cases,
snapping hip leads to bursitis, a painful swelling of the fluid-filled
sacs that cushion the hip joint.
Hip dysplasia - an abnormality of the hip socket that causes the joint to wear out faster
The Right Imaging for Determining the Right Treatment
“To be identified as an ideal hip preservation patient, you cannot
be experiencing any arthritis in your hip,” said Dr. Chen. “We’ll
identify the type of pain you’re feeling and how it’s impacting
your daily life and extracurricular activities."
Dr. Chen explained that imaging analysis is one of the tools used to determine
if hip preservation is an appropriate solution for a hip condition. These include:
- X-rays—to take measurements and evaluate the shape and risk factors
for impingement or instability.
- Magnetic Resonance Imaging (MRI)—to help identify and clearly reveal
fraying or tears of the cartilage and labrum.
- Computed Tomography (CT) Scans—“We use these if we’ve
identified a bony abnormality,” said Dr. Chen. Used infrequently,
this 3D scan indicates where an impingement exists.
"Additionally, we’ll perform a physical, review imaging to understand
if it’s truly your hip that’s the issue and determine appropriate
treatment,” said Dr. Chen.
All hip preservation patients initially receive non-operative treatment.
"They go through a minimum of three months and up to 12 months of
non-operative treatment,” said Dr. Chen.
He emphasized a study of non-operative management techniques indicating
that “82% of people managed non-operatively experienced significant
improvements following two years of treatment. People who addressed their
hip issues sooner were likely have a better outcome." He also noted,
“If you can modify life enough to live with the condition, that’s
always my recommendation.”
Arthroscopic Surgery for Hip Preservation
In some instances, arthroscopic surgery—a minimally invasive procedure—may
be required as an effective way to preserve the hip. “It is often
used for those who have already tried nonsurgical treatments and haven’t
developed significant arthritis,” said Dr. Chen. An orthopedic surgeon
will determine when surgery is needed, if you’re a candidate and
the appropriate procedure.
“For the hip arthroscopy procedure,” said Dr. Chen, “three
to four keyhole sized incisions are made. Recovery starts with physical
therapy the day after surgery and typically includes two weeks on crutches
and two weeks in a brace.”
This procedure results in quick recovery, minimal scarring and a return
to pre-injury activity, making the procedure ideal for athletes and those
20 to 55 years old.
Hip arthroscopy is NOT ideal for those:
- who are older,
- have an elevated BMI and are overweight,
- experience anxiety or depression,
- who have had symptoms for longer than two years, making it harder to fully recover
To request an appointment with
Austin W. Chen, MD, at the Boulder Center for Orthopedics and Spine call
To learn more,
view/download a PDF of slides shown during this lecture.