Too young for hip pain? You may not need a replacement

A total hip replacement may slow down patients who enjoy high-impact sports and alter how young athletes stay active for the rest of their lives. Hip preservation is an alternative treatment method that aims to conserve the body and avoid the need for hip replacement. Sports medicine specialists, Anthony Essilfie, MD, and Dheeraj Yalamanchili, MD, encourage young athletes to preserve their body now with hip preservation treatments to continue an active lifestyle.

Hip preservation is a set of procedures and therapies that aim to maintain the natural structure and function of the hip joint. Essilfie and Yalamanchili begin treatment with conservative options like activity modification and physical therapy to strengthen core, gluteal, and abductor muscles to take pressure off the hip or regain stability. If pain persists, they will localize the cause of pain and administer anesthetics and/or a steroid for anti-inflammatory effects. Younger patients may not receive the steroid to avoid tendon weakening.

Patients seeking more in their quality of life can learn about surgical options that are still less invasive than a total hip replacement. A hip arthroscopy is a minimally invasive outpatient procedure that allows surgeons to restore damaged tissue and shave the bone, causing an impingement. Essilfie says most young athletes experiencing hip pain have impingement where the ball and socket of the hip joint don’t fit together properly.

Other patients’ pain may be from hip instability as a result of hip dysplasia, where the pelvis doesn’t cover the femoral head. This can lead to referred pain to the low back or lateral hip pain due to increased demand placed on the surrounding muscles to compensate for the lack of pelvic coverage. A periacetabular osteotomy is then performed to cover the femoral head to allow for more stability.

“This procedure is a bit more involved but does provide great stability to the hip and avoids total replacements at a young age,” Essilfie says. “One of the significant advantages is preserving the patient’s natural makeup.”

Hip replacement surgery involves removing the damaged hip joint and replacing it with a prosthetic joint. While hip replacement is often necessary in severe cases of hip damage or deterioration, it does come with its risks, such as infection, loosening or dislocation of the prosthetic joint, and potential need for revision hip repalcements.

“The psychology surrounding hip pain is different. Often times young patients with hip pain have normal X-rays and are told that there is no solution,” Essilfie says. “A big part of my role is trying to encourage patients that we can make things better and get them back to their desires.”

If you are experiencing hip pain or mobility issues, it is essential to consult with a medical professional to determine the underlying cause and discuss the available treatment options. Explore the sports medicine options offered by the high-performing orthopaedic team at Loma Linda University Health.