Traditionally, hip pain treatment for children and young adults involved little more than a prescription of activity moderation, anti-inflammatory medicines and painkillers. Hip replacement is not the best treatment option for this young age group because of activity restrictions and the limited lifespan of the artificial joint, because of their growing bodies. In fact, a young patient who gets a hip replacement may require multiple hip surgeries over the course of his or her lifetime.
The first comprehensive orthopedic program in the Chicago area to address hip pain in children and young adults has been developed by orthopedic physicians at Rush University Medical Center. The goal of the Healthy Hip Program is to preserve the hip and help patients return to a full, active life. It offers alternatives to hip replacement to children and young adults who suffer from chronic hip pain.
The program will specialize in hip pain caused by injuries or disorders, including developmental hip dysplasia (or misalignment of the hip caused by abnormal development) or Perthes disease, that affect the growth of the head of the femur (the long bone in the upper leg that connects with the hip socket) or acetabulum (the hip socket or concave surface of the pelvis where the femur usual connects to create the hip joint).
"One of the benefits to having a healthy hip program for younger patients is being able to diagnose and treat these problems, which may help patients avoid or postpone possible total hip replacement in the future," says Monica Kogan, MD, a pediatric orthopedic surgeon at Rush University Medical Center.
Pain typically occurs during or just after physical activity, at the onset of joint disease. Over time, the pain becomes more frequent and many people have hip pain even when at rest. The pain can manifest itself in many areaslocally, in the groin or above the hip causing lower back pain. With time, the condition can worsen or cause damage to connecting joints and tissue.
"Some hip-joint deformities cause abnormal contact during hip motion that creates unbearable pain. The problem usually becomes evident in young adults and can often go undiagnosed for years. Now we can correct the problem and reduce or eliminate the pain," says Charles Bush-Joseph, MD, an orthopedic surgeon at Rush University Medical Center.
New technologies to diagnose and treat individuals with recurring and deteriorating hip conditions include hip arthroscopy, pelvic osteotomy and femoral head/acetabular osteoplasty:
The best possible approach for each individual seeking alternatives to hip replacement is determined by the skilled, team of orthopedic surgeons with the Healthy Hip Program.
Injuries to the cartilage surrounding the hip can occur with a variety of sports and recreational activities that include twisting and rotation. One of the procedures to improve this condition, called hip arthroscopy, is a procedure where a pencil-sized camera and miniature instruments are inserted through 1-centimeter incisions to allow for examination of the hip while repairing torn cartilage and removing bone spurs that once required open invasive surgery. Hip arthroscopy is less invasive than traditional surgical procedures, can treat a variety of hip problems and is done on an outpatient basis. Patients have an early and accelerated course of rehabilitation, and a faster return to full activity.
For young patients whose hip pain has been identified as being from dysplasia and who have very early hip arthritis, the procedure of choice is a periacetabular osteotomy. These patients may have been previously treated for dysplasia when they were younger or the dysplasia may be newly identified. This surgical procedure involves redirecting the acetabulum (socket) to cover the femoral head adequately. The goal is to create a more anatomic position to prevent any further arthritis from developing and improve pain. This reconstructive procedure has good longevity because the femoral head is then covered completely by healthy joint cartilage in the socket.
Another procedure, osteoplasty or femoral head reshaping, is ideal for individuals where the femoral head is too large for the hip socket causing unbearable hip pain. Young adults can suffer for years before being diagnosed. The procedure improves the range of motion and reduces any unwanted contact in the hip joint in order to eliminate pain. Depending on the severity, the hip may need to be dislocated. With both methods the site of interference is identified and assessed for lesions, or deterioration on the surface of the bones or cartilage, and the femoral head is reshaped with the focus on improving the clearance for hip motion and alleviation of friction.
More Information at Your Fingertips:
- For more information about other orthopedic care at Rush visit our Orthopedic Surgery home page.
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Please note: All physicians featured in Discover Rush Online are on the medical faculty of Rush University Medical Center. Some of the physicians featured are in private practice and, as independent practitioners, are not agents or employees of Rush University Medical Center.
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