Monday Medical: New surgical technique resolves hip pain
September 22, 2013
Steamboat Springs — Linda Sheean, a massage therapist in Steamboat Springs, said the pain in her right quadriceps muscle felt like a knife stab. It was relentless, extreme and puzzling.
Sheean always had been active, enjoying Nordic and Alpine skiing, biking and hiking. At age 58, she was trim and fit.
"I tried several alternative things, including yoga, to try to get at the pain," she said. "Nothing was helping, and I had no clue what was going on in my thigh. Finally, I couldn't bear it anymore."
Sheean went to see orthopedic surgeon Dr. Bryan Bomberg, who discovered a labral tear in her right hip. After identifying the condition, he recommended hip arthroscopy.
"He showed me everything that was going on in my body, so I could understand what he was going to do," Sheean said. "He explained that it was a relatively new procedure."
Sheean had the surgery in June 2012. It was a success.
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"My pain was gone completely right after surgery, and I had a quick recovery," she said. "I was pretty darn mobile by six or eight weeks. Dr. Bomberg was attentive, and I felt comfortable calling him with questions."
Bomberg, who has been on the Yampa Valley Medical Center staff and in private practice in Steamboat Springs since 1993, said hip arthroscopy has emerged as the most effective way to treat a painful condition called femoroacetabular impingement, or FAI. This is what was causing Sheean's excruciating pain.
"We are recognizing FAI more, particularly in young athletes," Bomberg said. "Problems that used to be attributed to hernia or groin pull are turning out to be cases of FAI. One key to diagnosis is that we are using a much higher grade of MRI, and we're able to see it more clearly."
FAI is caused by an anomaly in the hip, either an overhanging cup or a bump on the femoral head, Bomberg said. This results in pinching of the labrum tissue and sometimes a labral tear. If not treated, some cases of FAI can progress to cause cartilage damage and early osteoarthritis.
"Our population here is athletic and activity oriented, and we are starting to see more young athletes with this problem," Bomberg said. "Young women are especially prone to it."
During the past month, Bomberg has seen three teenage girls, all high school athletes, who have FAI. However, young women aren't the only vulnerable population.
"We also see middle-age people," he said. "FAI manifests itself as people are doing certain activities. Motorcycle riding is a big risk factor because of the flexion of the legs and hips."
Bomberg trained in hip arthroscopy in San Francisco with Dr. Thomas Sampson, who developed the procedure in 2001. This technique has replaced the previous "open dislocation surgery," which resulted in a much longer recovery time.
"It has evolved to the point where it is a day surgery," Bomberg said. "We do a microfracture behind the cartilage and let the cartilage seal back to the bone. Early weight-bearing helps the healing. An athlete can be back to full sports participation several months after surgery."
Bomberg is one of several Steamboat Springs orthopedic surgeons who perform hip arthroscopy at Yampa Valley Medical Center.
More than a year after surgery, Sheean is enjoying her pain-free activities and is pleased with her decision to have surgery.
"I believe in a balance between alternative healing techniques and medicine," she said. "At times, we just need Western medical technology."
Christine McKelvie is a writer/editor for Yampa Valley Medical Center. She can be reached at firstname.lastname@example.org.