Hip Specialties
Your hips carry the vital function of supporting your weight while allowing you the range of motion to sit, stand and walk. Their delicate balance of bones, ligaments and joints make them susceptible to wear and tear over time. Arthritis, injuries, strains, inflammation, clicking and popping, and congenital diseases can compromise joints, leading to pain in the hip and groin and overall restricted motion.
Hip
Hip Sports Injuries
Athletes tend to have fairly specific types of injuries to the hip itself, these can be wide ranging, and they can be frustrating for the athlete, who simply wants to get better and get back into competition. It is important to diagnose a hip injury accurately, to maximize outcomes, and to decrease time of recovery. Many issues can be resolved without surgery, however if these become persistent or refractory to non-operative management, occasionally surgeries are necessary.
Arthroscopy
Arthroscopy (also called arthroscopic or keyhole surgery) is a minimally invasive surgical procedure on a joint in which an examination and sometimes treatment of damage is performed using an arthroscope, an endoscope that is inserted into the joint through a small incision. Arthroscopic procedures can be performed during ACL reconstruction.
Labral Injuries
The labrum is a piece of fibrocartilage (rubbery tissue) attached to the rim of the shoulder socket that helps keep the ball of the joint in place. When this cartilage is torn, it is called a labral tear. Labral tears may result from injury, or sometimes as part of the aging process. Symptoms and treatment vary depending on the type and severity of the tear.
Cartilage Repair (Osteochondral Lesions)
An osteochondral lesion is a defect in the cartilage of a joint and the bone underneath. Cartilage is a connective tissue that covers the bones between joints. When there is a break, tear, separation, or disruption of the cartilage that could be referred to as an osteochondral lesion. The bone right underneath the cartilage will also be injured. The knee joint, ankle joint, and elbow joint are common places where this defect occurs.
Hip Rotational Deformities and Limb Lengthening
Rotational deformities can frequently occur in childhood, evidenced by the appearance of their toes either pointed in (in-toeing) or out (out-toeing), and if caused as a part of normal development generally corrects itself once the child is weight bearing – without long lasting impact to the musculoskeletal system. If the deformity is caused by another problem, it may persist into adulthood and become increasingly more difficult to identify.
Total Hip Replacement
Hip replacement is a surgical procedure in which the hip joint is replaced by a prosthetic implant, that is, a hip prosthesis. Hip replacement surgery can be performed as a total replacement or a hemi (half) replacement. Such joint replacement orthopaedic surgery is generally conducted to relieve arthritis pain or in some hip fractures. A total hip replacement (total hip arthroplasty or THA) consists of replacing both the acetabulum and the femoral head while hemiarthroplasty generally only replaces the femoral head.
Complex Lower Extremity Construction
Fractures Delayed/Nonunions
Nonunion is permanent failure of healing following a broken bone unless intervention (such as surgery) is performed. A fracture with nonunion generally forms a structural resemblance to a fibrous joint, and is therefore often called a "false joint" or pseudoarthrosis (the Greek stem "pseudo-" means false and "arthrosis" means joint). The diagnosis is generally made when there is no healing between two sets of medical imaging such as X-ray or CT scan. This is generally after 6–8 months.
Nonunion is a serious complication of a fracture and may occur when the fracture moves too much, has a poor blood supply or gets infected. Patients who smoke have a higher incidence of nonunion. The normal process of bone healing is interrupted or stalled.
Since the process of bone healing is quite variable, a nonunion may go on to heal without intervention in a very few cases. In general, if a nonunion is still evident at 6 months post injury it will remain unhealed without specific treatment, usually orthopedic surgery. A non-union which does go on to heal is called a delayed union.
Angular Deformities of Lower Extremity
Angular deformities of the lower limbs are common during childhood. In most cases this represents a variation in the normal growth pattern and is an entirely benign condition. Presence of symmetrical deformities and absence of symptoms, joint stiffness, systemic disorders or syndromes indicates a benign condition with excellent long-term outcome. In contrast, deformities which are asymmetrical and associated with pain, joint stiffness, systemic disorders or syndromes may indicate a serious underlying cause and require treatment.
Chronic Bone Infection/Osteomyelitis
Osteomyelitis (OM) is an infection of bone. Symptoms may include pain in a specific bone with overlying redness, fever, and weakness. The long bones of the arms and legs are most commonly involved in children, while the feet, spine, and hips are most commonly involved in adults.
The cause is usually a bacterial infection, but rarely can be a fungal infection. It may occur by spread from the blood or from surrounding tissue. Risks for developing osteomyelitis include diabetes, intravenous drug use, prior removal of the spleen, and trauma to the area. Diagnosis is typically suspected based on symptoms. This is then supported by blood tests, medical imaging, or bone biopsy.
Bone Lengthening (femur, tibia)
Bone lengthening works by separating the bone and distracting (pulling apart) the bone segments very slowly so that new bone continues to form in the gap. As the bone segments are slowly distracted, the bone regenerates, resulting in increased length
Complex Ankle Reconstruction
Ankle ligament reconstruction is a surgery to tighten and firm up one or more ankle ligaments on the outside of your ankle. It’s also known as the Brostrom procedure. Your ankle is a hinge joint that allows motion up and down, and from side to side. Your foot and ankle have several ligaments.
Ilizarov Ring External Fixator and Spatial Frames
External fixation is a surgical treatment wherein rods are screwed into bone and exit the body to be attached to a stabilizing structure on the outside of the body. It is an alternative to internal fixation, where the components used to provide stability are positioned entirely within the patient's body. It is used to stabilize bone and soft tissues at a distance from the operative or injury focus. They provide unobstructed access to the relevant skeletal and soft tissue structures for their initial assessment and also for secondary interventions needed to restore bony continuity and a functional soft tissue cover.
Magnetic Lengthening Nails
The recent developed remote-controlled magnetically driven lengthening nail is a new and promising advancement in the field of limb lengthening. Studies have shown that patients undergoing femoral lengthening using this nail demonstrated better consolidation indices, better knee mobility and decreased complication rates compared with conventional external fixation.