Monday Medical: New hip surgery available

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There is new hope for people who have chronic hip pain caused by a pinching or impingement within the joint. Minimally invasive arthroscopic surgery is now being performed at Yampa Valley Medical Center to alleviate this problem.

"We have been doing hip arthroscopy for some time, to clean out the joint and take care of inflammation," orthopaedic surgeon Bryan Bomberg, M.D., said. "Now we are also able to use this technology to relieve impingement."

Jeannie Albee, a recently retired second-grade teacher from Craig, had the surgery at YVMC in early February. She currently is in the second phase of her rehabilitation program with physical therapist Rich Sadvar of Craig Physical Therapy.

"This new surgery is the only way to go," Albee said. "I had pain for a good 10 years before I went ahead and got it fixed. The pain radiated all through my pelvic area and down my leg - it wasn't just in my hip."

Albee had reached the point where she had difficulty keeping up with her second-graders in the classroom. She was limping, and it hurt to ride her bicycle. Sadvar recommended that she see an orthopaedic surgeon for her hip.

"A lot of hip pain has some degree of what is called 'femoral acetabular impingement,' which is a pinching between the neck of the femur and the rim or cup of the hip," Bomberg explained. "Formerly, this pain was seen simply as a precursor to arthritis. It may have been underdiagnosed or mislabeled as 'early arthritis' or bursitis.

"Even when impingement was suspected, the previous surgical technique required an open incision and often a dislocation and relocation of the hip," Bomberg said. "Cutting through the muscle was not an appealing prospect, so many people simply lived with the pain."

Impingement often causes additional problems within the hip, such as cartilage tears and bone damage. Albee's surgery required repair of a torn labrum (cartilage rim) and some bone removal from the femur.

"For the first four days, I was in quite a bit of pain from the surgery, then that changed to feeling sore and achy, and each day I felt better," Albee said. "I could tell almost immediately by moving my leg that my hip was fixed."

Hip impingement has a variety of causes, Bomberg said. It can develop naturally due to the formation or anatomy of the hip. Calcification within the cartilage can lead to stiffening of the labrum and irritation to tissue and bone.

"It occurs in a wide age range, anywhere from someone's 20s to their 60s," he added. "If it is caught early and surgically repaired, it could delay or even prevent the need for a total hip replacement."

"Two more years and I probably would have needed a hip replacement," Albee said. "That was not something I wanted to do. My husband and I like to get out and hike and do outdoor things. I want to stay active."

Bomberg said the surgery can be performed on an outpatient basis. He recommends physical therapy as an integral part of the recovery process.

Albee was on crutches for six weeks, then began weight-bearing exercises. She now is riding a stationary bicycle 30 minutes a day and doing stretching and strengthening exercises under Sadvar's guidance.

"I'm aware of some pain, but I can forget about it most of the time," she said. "Dr. Bomberg told me it would take a year for the cartilage to heal. That sounds like a long haul, but it's not that bad. I can feel my muscles growing stronger.

"I would do this again in a heartbeat. It's worth it."

Christine McKelvie is public relations director of Yampa Valley Medical Center.

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