Hip Pain

How is Arthroscopic Hip Surgery Different?

ArthroscopyArthroscopy (also called Arthroscopic surgery) is a surgical procedure by which the internal structure of a joint is examined for diagnosis (and possibly treated) using an instrument called an arthroscope. Arthroscopy gives doctors a clear view of the inside of a joint, and helps them diagnose and treat joint problems. Hip arthroscopy has been slower to evolve than arthroscopy of other joints such as the knee or shoulder, mostly because the hip joint is much deeper in the body and therefore harder to access, but can be very effective at treating certain hip conditions.

Arthroscopic hip surgery is radically different than traditional open surgery, and may be considered before one opts for a full hip replacement surgery. Non-operative measures should always be considered first — rest, behavior modification, physical therapy and anti-inflammatories may work to alleviate reversible disorders. If non-operative measures aren’t effective and you do elect for surgery, a procedure may be done arthroscopically instead of by traditional surgical techniques, as it usually causes less tissue trauma, may result in less pain, and may promote a quicker recovery.

Hip Replacement Surgery 101

hip replacementThe hip is one of the body’s largest and most important joints. It allows us to walk, run and jump, and bears our body’s weight and the force of the muscles of the hip and leg. If your hip has been severely damaged—by a fracture, arthritis, osteonecrosis or other conditions–common activities such as walking or getting in and out of a chair may be painful and difficult. You may even feel uncomfortable while resting.

If other alternatives such as medications, the use of walking supports, or changes to daily activities do not effectively help your symptoms, hip replacement may be a viable solution and you should consult with your physician to learn more. Generally, hip replacement surgery is a safe and effective procedure that can help you get back to enjoying everyday activities.

Hip Surgery: Hip Arthroscopy 101

Hip arthroscopy is a surgical procedure that is performed through small (about 1 centimeter) incisions using an arthroscope (camera used to visualize the inside of the joint) inside of a hip joint. Hip arthroscopy is typically performed in an outpatient setting, so patients can usually go home the day of surgery after a one to two hour recovery in the outpatient recovery area. Although it will take about 6 months to return to sport activity, close to 85-90% of patients will return to their normal activity after they recover from their hip arthroscopy surgery.

Emory Orthopaedics, Sports & Spine has a great team of operative and non-operative physicians who are specialized in treating athletes who need hip arthroscopies. Watch this short video to find out more about our unique program.

Dr. Maughon Discusses the Ins & Outs of Joint Replacement Surgery

Joint replacement surgery is a procedure that should only be recommended when all other modes of treatment to eliminate your pain have been exhausted. Almost any joint in the body can be replaced, but most commonly replaced joints are the knee, shoulder and the hip. If you are referred for joint replacement the goal at Emory Orthopaedics, Sports & Spine is to get an athlete back to a similar level of play or activity after a surgery. In an aging athlete, joint replacement is typically done for pain relief so the patient is allowed to lead an active life. Although, many patients will be able to do all the activities they did before the joint replacement, we recommend doing activities that do not put a lot of pressure on the joint such as swimming, ice skating and doubles tennis. Watch this short video about joint replacement and details on what makes joint replacement surgery at Emory different.

When it Comes to Your Health, are High Heels Worth the Price of Looking Good?

High Heels Back PainEmory Orthopaedics, Sports and Spine physicians Kyle Hammond, MD  and Oluseun A. Olufade, MD recently participated in “Ladies Night Out”  at Emory Johns Creek Hospital.

The Ladies Night Out event is an annual health fair held by Emory Johns Creek Hospital for women to talk with physicians and other providers in the Johns Creek and North Atlanta communities and learn about services near them.

At the Emory Orthopaedics, Sports & Spine table, Drs. Hammond and Olufade spoke with women about potential injuries that could occur from wearing high heeled shoes and what women might be able to do to help prevent injuries to their backs, ankles, feet, hips and knees.

As a fun activity at the Ladies Night Out event, we also had a free drawing for high heeled shoes that were displayed at the table.  Five lucky women went home with a new pair of shoes and lots of tips to prevent orthopedic injuries.

Emory Orthopaedics and Spine Team at the Ladies Night Out Event
Below are 5 orthopedic conditions or injuries related to wearing high heels and tips on how you can prevent them:

ACHILLES TENDINITIS

Symptom: Pain & swelling in lower calf and heel cord resulting in decreased calf flexibility

Achilles Tendinitis Prevention:

  •  Calf stretches with towel or band
  • Calf raises / strengthening exercises
  • Heel pads
  • Wear short heels or flats

ANKLE SPRAIN / FRACTURE

Symptom: Pain, bruising, swelling and inability to walk

Ankle Sprain & Fracture Prevention:

  • Wear short, wide heels (no stilettos)
  • Single leg balancing
  • Ankle ‘A, B, Cs’

BUNIONS

Bunion Symptom: Tenderness and prominence inside of the big toe joint

Bunion Prevention:

  • Ensure proper shoe size & fit
  • Wear short heels with wide toe box
  • Use pads to cushion bunions
  • Wear heels for brief periods of time if possible

KNEE AND HIP INJURIES

Symptom: Muscles in your hip and knee have to work harder when you wear heels as muscles become fatigued and more prone to injury

Possible Injuries:

  • Muscle strain
  • Tendinitis
  • Meniscus tear
  • Hip impingement

Hip & Knee Injury Prevention:

  • Stretch hamstrings, quads, & hip
  • Strength training for lower body
  • Alternate heels with flats during the work week
  • Balance exercises

LOW BACK PAIN

Low Back Pain Causes: Normal center of gravity changes, increasing the curvature of your low back and tilting your pelvis forward.

Low Back Pain Prevention:

  • Change into flats for long walking distances
  • Strengthen your core (crunches & low back extension exercises)

Although high heels look nice and are fun to wear at special events, try to limit the high heels to special occasions and stick with flats for your day to day activities.  Your body will thank you!

About Dr. Kyle Hammond

Dr. Hammond is an orthopaedic surgeon new to the Emory Orthopaedics faculty.  He recently completed his fellowship at the University of Pittsburgh Medical Center.  While at the University of Pittsburgh he was the Associate Head Team Orthopaedic Surgeon for both the Duquesne University Football team and the University of Pittsburgh Men’s Basketball team.  He also worked as a Team Physician for the Pittsburgh Steelers, the Pittsburgh Penguins, the University of Pittsburgh athletics, Robert Morris College athletics, as well as the Pittsburgh Ballet.

Dr. Hammond sees patients at Emory Johns Creek Hospital, as well as Emory Orthopaedics & Spine Center in Atlanta.  Dr. Hammond has a special interest in the overhead/throwing athlete, ligament injuries to the knee, Tommy John surgery, joint preservation surgery, and is one of the few fellowship trained hip arthroscopists and concussion specialists in Georgia.

About Dr. Oluseun A. Olufade

Dr. Olufade is board certified in Physical Medicine & Rehabilitation and Interventional Pain Medicine. He completed fellowship training in both Sports Medicine and Interventional Pain Medicine. During his fellowship training, he was a team physician for Philadelphia Union, a major league soccer (MLS) team, Widener University Football team and Interboro High School Football team.

Dr. Olufade employs a comprehensive approach in the treatment of  sports related injuries and spinal disorders by integrating physical therapy, orthotic prescription and minimally invasive procedures. He specializes also in concussion, tendinopathies and platelet rich plasma (PRP) injections. He performs procedures such as fluoroscopic-guided spine injections and ultrasound guided peripheral joint injections. Dr. Olufade individualizes his plan with a focus on functional restoration. Dr. Olufade sees patients at Emory Johns Creek Hospital.

About Emory Ortho, Sports and Spine in Johns Creek and Duluth

Emory Orthopaedics, Sports & Spine has recently opened two new clinics, one in Johns Creek and one in Duluth.  Emory physicians, Kyle Hammond, MD, and Oluseun A. Olufade, MD see patients in Johns Creek.  Mathew Pombo, MD and T. Scott Maughon see patients in Duluth.  Our new clinic locations care for a full range of orthopedic conditions including: sports medicine, hand/wrist/elbow, foot/ankle, joint replacement, shoulder, knee/hip, concussions, and spine.

To schedule an appointment call 404-778-3350

Related Resources:

Learn all about Hip or Knee Replacements

The decision to get a hip or knee replaced is a difficult one for many patients.  Hip and knee replacements are typically advised only when all other options have not worked for you.  If you are considering a hip or knee replacement or already have had one and want to speak to a physician, join Emory Orthopedic Surgeon, Thomas Bradbury, MD on Tuesday, June 11, 2013 at noon for an online web chat on Hip and Knee Replacements.  He will be available to answer questions such as:

• What are hip and knee replacements?
• Why have the surgery?
• Who are candidates for hip or knee replacements?
• What are the newest advances in Hip and Knee replacements?
• What is Emory’s approach on when to get knee or hip replacement surgery?
• What is the recovery after a hip or knee replacement?
• What types of exercise are suitable for someone with hip or knee replacements
• What kind of outcome can you expect?

Come prepared to ask your questions and learn more about your options!

CHAT TRANSCRIPT

About Dr. Bradbury

Thomas Bradbury, MD

Dr. Bradbury is an Assistant Professor of Orthopaedic Surgery at Emory.  He specializes in hip and knee arthroplasty.  He really enjoys this area of orthopaedic surgery because of the consistency of success in the properly selected patient. Dr. Bradbury’s professional goal is the improvement in quality of life for patients with pain secondary to hip and knee problems.

His research interests center around infections involving hip and knee replacements which are rare, but difficult problems. Dr. Bradbury is researching the success rate of current treatment methods for hip and knee replacement infections caused by resistant bacteria (MRSA). Through his research, he hopes to find better way to both prevent and treat periprosthetic hip and knee infections.

Related Resources

Osteoarthritis Pain Treatment – Using your own Stem Cells?

hip resurfacing procedureIt is reality now! Physicians at Emory Orthopaedics & Spine are among a select group of physicians around the country to offer a unique procedure using stem cell injections to relieve osteoarthritis (OA) pain. During the procedure, the physician extracts stem cell blood from the bone marrow in a patient’s hip and then injects the stem cells directly into the patient’s damaged joint. The stem cells are from the patient’s own body so the risk of rejection is very low.

Hear first hand from Dr. Mautner and one of our patients how this new treatment option is helping relieve pain from Osteoarthritis:

About Ken Mautner, MD

Ken Mautner, MD is an assistant professor in the Department of Physical Medicine and Rehabilitation and the Department of Orthopedic Surgery. Dr. Mautner started practicing at Emory in 2004 after completing a fellowship in Primary Care Sports Medicine at the American Sports Medicine Institute in Birmingham, Alabama. He is board certified in PM&R with a subspecialty certification in Sports Medicine. Dr. Mautner currently serves as head team physician for Agnes Scott College and St. Pius High School and a team physician for Emory University Athletics. He is also a consulting physician for Georgia Tech Athletics, Neuro Tour, and several local high schools. He has focused his clinical interest on sports concussions, where he is regarded as a local and regional expert in the field. In 2005, he became one of the first doctors in Georgia to use office based neuropsychological testing to help determine return to play recommendations for athletes. He also is an expert in diagnostic and interventional musculoskeletal ultrasound and teaches both regional and national courses on how to perform office based ultrasound. He regularly performs Platelet Rich Plasma (PRP) injections for patients with chronic tendinopathy. Dr. Mautner also specializes in the care of athletes with spine problems as well as hip and groin injuries.

Related Resources

Take-aways from our Pediatric Orthopaedic Hip and Spine Chat with Dr. Fletcher

On February 5, 2013, Dr. Nicholas Fletcher, Emory Pediatric Orthopaedic Surgeon held a  live web chat to answer questions pertaining to the newest treatment options for pediatric orthopedic hip and spine conditions such as scoliosis, kyphosis, hip dysplasia, leg length differences and femoroacetabular impingement.

One of the most common pediatric orthopedic problems is hip dysplasia. Hip dysplasia occurs when the hip socket does not form correctly, which can lead to hip dislocation as a child grows, stated Dr. Fletcher in the chat. Unfortunately, hip dysplasia cannot be diagnosed in a child before birth, a great question which was asked by one of the chat participants. While hip dysplasia is not particularly common, mild abnormalities of the hip socket are regularly seen at birth, but parents should not be alarmed, as these abnormalities typically get better within a couple of months of a child’s life. One of the pediatric hip dysplasia treatment options Dr. Fletcher mentioned in the chat is called the Ganz Osteotomy, a procedure available at Emory. The procedure is used to realign the hip and settings of hip dysplasia when it is found in teenagers and adults.

Participants were also interested to learn that Emory is one of only a few centers in the southeast that offer hip preservation surgeries. Hip preservation is a surgical approach to hip problems in teens and young adults designed to prevent the need for hip replacement down the road. It usually involves realigning an abnormal hip socket into a more normal position or removing bone spurs in the hip that could lead to early arthritis.

Dr. Fletcher provided some great insights and answered some hard pressing questions from chat participants. If you would like to know more about the causes and treatment options of Pediatric Orthopaedic Hip and Spine conditions be sure to take a look at the live web chat transcript. Also, for more information on Scoliosis and on how to become a patient visit Emory Orthopedic and Spine online today.

Related Resources

Does Your Child Have Hip or Spine Problems? Chat Live with Dr. Fletcher!

Pediatric Orthopedic ChatDid you know that children can be affected by a wide array of orthopaedic hip and spine issues? Scoliosis, kyphosis, hip dysplasia, leg length differences and femoroacetabular impingement are just a few of the conditions our team sees most commonly from pediatric patients. These conditions can lead to time away from school and chronic pain and disability later in life.

Join Emory Pediatric Orthopaedic surgeon, Dr. Nicholas Fletcher, for a live interactive web chat on Tuesday, February 5 at noon to get all your questions about symptoms, causes and the newest treatment options for pediatric orthopedic hip and spine conditions answered! See you there!


Sign Up for the Chat


About Dr. Fletcher
Dr. Nicholas FletcherDr. Fletcher takes care of all pediatric orthopaedic trauma, neuromuscular disorders, leg length differences, foot conditions, and angular deformities of the lower limbs. In addition, the management of pediatric spinal and hip conditions are particular areas of expertise. Dr. Fletcher also specializes in pediatric and young adult hip conditions including hip dysplasia, femoroacetabular impingement (FAI), perthes disease, avascular necrosis, and slipped capital femoral epiphysis. He is one of only a handful of surgeons in the southeast with expertise in the Ganz or periacetabular osteotomy (PAO) for hip dysplasia and the modified Dunn osteotomy for slipped capital femoral epiphysis. He takes care of children of all ages with hip conditions in addition to young adults with hip dysplasia and impingement.

Did you know that July is Juvenile Arthritis Awareness Month?

We are all painfully aware that arthritis affects many older adults, but did you know that kids can develop juvenile arthritis?

Approximately 294,000 children age 16 or younger are affected by pediatric arthritis and rheumatologic conditions.
In adults, arthritis typically affects the joints. While juvenile arthritis can cause bone and joint growth problems, it also can affect the eyes, skin, and gastrointestinal tract.

The most common symptoms of juvenile arthritis are joint swelling, pain, and stiffness that won’t go away, particularly in the knees, hands, and feet. Symptoms are generally worse in the morning and after naps. Other signs of juvenile arthritis include:

•    Limping due to a stiff knee

•    Excessive clumsiness

•    High fever and skin rash

•    Swelling in the lymph nodes

The most common type of juvenile arthritis is juvenile idiopathic arthritis. (Idiopathic means “from unknown causes.”) You may have heard this referred to as juvenile rheumatoid arthritis. This type of arthritis is diagnosed when a child has swelling in one or more joints for at least six weeks.

There are several different types of juvenile idiopathic arthritis. The type is usually determined by the number of joints affected as well as by the results of a rheumatoid factor blood test. While children may have a genetic predisposition that makes them more likely to develop the disease, at this point, researchers have not determined a direct cause, and there’s no evidence that toxins, foods, or allergies can cause it. Most children with juvenile arthritis experience remission, when the symptoms get better or go away, and times when symptoms flare, or get worse.

If your child has juvenile arthritis symptoms, the first thing to do is get an accurate diagnosis. Your child’s pediatrician can run tests that will rule out other potential causes, but if the signs point to juvenile arthritis, he or she may suggest you make an appointment with a pediatric rheumatologist.

There is no cure for juvenile arthritis; however, a number of treatments can improve your child’s quality of life, including:

•    Nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and analgesics to help relieve inflammation and control pain

•    Disease-modifying anti-rheumatic drugs (DMARDs) and a biologic response modifiers (biologics), which can alter the course of the disease, put it into remission, and prevent joint damage

•    Splints to help keep joints in the correct position and to relieve pain and orthopedics or shoe inserts to compensate for any difference in leg length or to improve balance

•    Physical therapy to help restore motion and flexibility in joints that have become stiff and occupational therapy to help children learn how to do basic activities without aggravating their arthritis

And, of course, it’s super important for kids with juvenile arthritis to eat healthy foods and get regular moderate exercise, to keep joints strong and flexible.

Does your child have juvenile arthritis? How does your family cope? We welcome your questions and feedback in the comments section below.