Author Archives: Tigran Garabekyan, M.D.

Back problems can routinely manifest into hip troubles. Experts state that there is tremendous overlap. Ordinary wear and tear in the body can cause pain in the hip and back region. 

Southern California Hip Institute (SCHI), led by board certified orthopedic surgeon Dr. Tigran Garabekyan, provides orthopedic surgery to patients in Los Angeles, Century City, Beverly Hills, CA, and surrounding locations.

Is Your Hip Causing Problem?

Hip problems generally produce groin pain as well. This is because the actual hip joint is located near the spine. Groin pain in most cases is thought to be the result of hip problems, unless proven otherwise. However, pain above the belt line is not because of a hip issue. 

Osteoarthritis of the hip joint is usually the reason for hip pain. You may be suffering from hip arthritis if:

• Discomfort is on and off or becomes more frequent with time
• Pain is in the groin area
• Pain worsens because of walking, standing, and performing other activities, but is relieved when you rest
• Your hip area feels stiff
• You have a limp while walking

AVN or avascular necrosis is a serious condition characterized by the death of hip joint. The pain is more constant and worse as compared to osteoarthritis.

Is Your Spine Causing Problem?

Majority of lower spine problems are the result of a herniated disc pressing on the spinal column nerves. This results in sciatica pain that radiates through the hip. You may be experiencing a herniated disc if the pain:

• Shoots down your leg
• Is limited to your hip, buttocks, or back
• Improves when walking or standing
• Worsens with bending or sitting

You should consult with your doctor if you have a history of cancer, night sweats, or night pain. The problem could be more serious than you think. Some people suffer from problems in both lower back and hips. This is not surprising since both spinal changes and osteoarthritis are becoming more common with each passing decade.

It is Difficult to Identify the Pain Source

You should seek help from a spine or hip specialist if the source of your pain is not easy to pinpoint. The specialist may order a lidocaine injection or perform therapeutic/diagnostic hip injection under ultrasound or fluoroscopy. 

If the problem is in your hip area, this treatment will relieve symptoms by numbing the hip joint immediately. Your doctor will know the root of the trouble is elsewhere if the pain doesn’t improve. This technique can be used for ruling out back pain as well. 

Relieving Hip Pain

• You should see an orthopedic surgeon who will likely prescribe NSAIDs.
• Shedding extra pounds is vital for relieving hip pain. This also improves your chances of successful results if you ever require hip surgery. 

Relieving Back Pain

• You should see an orthopedic surgeon for NSAIDs. Don’t forget to stay active.
• You may need to schedule physical therapy after two weeks for strengthening back muscles that support your spine.

Board certified orthopedic surgeon Dr. Tigran Garabekyan of the Southern California Hip Institute (SCHI) receives patients from Los Angeles, Century City, Beverly Hills, CA, and nearby areas for orthopedic surgery. 

Contact the Southern California Hip Institute

Dr. Tigran Garabekyan is a board certified orthopedic surgeon specializing in hip preservation. To learn more about Southern California Hip Institute or to schedule a consultation, click here to contact us or call:

Century City / Los Angeles: 310.574.0375

Serving patients in Los Angeles, Beverly Hills, Santa Monica, Century City, West Hollywood, North Hollywood Encino, Sherman Oaks, Van Nuys, Burbank, Glendale and other neighboring cities in the greater Los Angeles, California area.

Also visit http://www.drgorthopedics.com/

Many people that get total hip replacement surgery often claim the surgery to have changed their lives and helped them in regain independence, enjoy recreational activities, and return to work. However, is it really worth paying for a hip surgery? You may find it difficult to peg a price on positive results.

Often, patients are responsible for a portion of the health care bill even when the procedure is covered under insurance. You can attain a better understanding of cost of treatment and insurance plans to calculate “out-of-pocket” expenses.

Southern California Hip Institute (SCHI), led by board certified orthopedic surgeon Dr. Tigran Garabekyan, provides orthopedic surgery to patients in Los Angeles, Century City, Beverly Hills, CA, and surrounding communities. 

Factors Influencing Surgery Cost of Total Hip Replacement 

The cost of getting a hip replacement surgery can differ depending on the quality of care and hip surgeon’s skills. Types of implants used, complexity of surgery, and venue of the surgery have an impact on the overall treatment cost as well. 

Cost of surgery may also vary depending on the location of the surgeon’s practice. This is because rent, overhead costs, facility maintenance, regulatory burden, and malpractice insurance depends on the city or town. 

Multiple Cost Elements

Total hip replacement incurs costs before, after and during the surgery. You may have multiple healthcare providers taking care of you to ensure successful results. Before the surgery, your orthopedic surgeon will evaluate your overall health. This is to make sure you can undergo the surgery safely. 

Patients may also be offered help with smoking cessation, weight loss and other health risks for improving their overall health before the surgery. This will allow for successful results. 

During the surgery, you would be cared for by the anesthesia team, operative staff, and the primary surgeon. These team members and their services incur additional costs. Following the surgical procedure, your health will be monitored by nurses at the post-acute care unit. You would be then transferred to the orthopedic room where another team will take care of you. 

Nutritionists, nurses, nursing aides, physical therapy assistants, discharge planners and nurse practitioners take care of patients recovering from surgery. Various tests, x-rays, supplies, and medications will be ordered at every step of the process. 

The type of hip implant you choose will affect the overall price of the total joint replacement surgery as well.

Post-operative Costs

Typically, patients are required to remain in hospital for 1 – 3 days before being discharged. There are several other costs associated with the procedure, such as rehabilitation program and physical therapy. You may need to spend more if you are sent to an inpatient rehabilitation center or a skilled nursing facility. 

In general, outpatient therapy usually costs significantly less. It’s crucial that you speak with your physician about the most cost-effective option for your procedure. This should be done during the initial consultation for your hip replacement procedure.

Board certified orthopedic surgeon Dr. Tigran Garabekyan of the Southern California Hip Institute (SCHI) receives patients from Los Angeles, Century City, Beverly Hills, CA, and nearby areas for orthopedic surgery.

Contact the Southern California Hip Institute

Dr. Tigran Garabekyan is a board certified orthopedic surgeon specializing in hip preservation. To learn more about Southern California Hip Institute or to schedule a consultation, click here to contact us or call:

Century City / Los Angeles: 310.574.0375

Serving patients in Los Angeles, Beverly Hills, Santa Monica, Century City, West Hollywood, North Hollywood Encino, Sherman Oaks, Van Nuys, Burbank, Glendale and other neighboring cities in the greater Los Angeles, California area.

Also visit http://www.drgorthopedics.com/

Chronic hip pain can have an effect on your everyday life. This pain can make it uncomfortable to stand, sit, or move around. It can also prevent you from completing your favorite activities. Hip replacement procedure may provide you with relief. However, everyone is not a suitable candidate for the surgery. 

Southern California Hip Institute (SCHI), led by board certified orthopedic surgeon Dr. Tigran Garabekyan, provides orthopedic surgery to patients in Los Angeles, Century City, Beverly Hills, CA, and surrounding locations.

When to Consider Hip Replacement Surgery?

You may benefit from getting a hip replacement procedure if your hip pain is not improving with lifestyle changes, medication, and other conventional treatments. Your surgeon may also recommend the procedure if you have serious hip joint damage because of an injury or the following chronic conditions:

• Severe injuries: post-traumatic arthritis can be the result of serious hip injuries. You may also suffer from avascular necrosis if the injury causes amount of blood flow to get restricted to the femoral head in the joint. 
• Arthritis: Rheumatoid arthritis and osteoarthritis can result in ongoing and severe stiffness and hip pain.
• Severe injuries: post-traumatic arthritis can result in serious hip injuries
• Childhood hip problems: You may develop arthritis if you suffered from hip problems in your childhood. This is even when you received treatment for the condition.

Ideal Candidacy

An orthopedic surgeon will determine whether you are an ideal candidate or not by considering various factors. They will determine whether the underlying issue is attributed to an entirely different problem.

Hip Arthritis

Arthritis is the first factor for hip replacement. The orthopedic surgeon you choose will ensure you are suffering from hip joint arthritis and not any other condition, like muscle or tendon inflammation. They will have a look at your MRI scans and x-rays to determine where the arthritis is and its severity. 

The type of symptoms experienced is also an important factor. Arthritis is complex in nature with many people showing it on their x-rays without any attributable symptoms. This is why the surgeon will examine you thoroughly to understand where the pain is emanating from. 

Treatment History

The surgeon will take a look at your treatment history before labeling you as an ideal candidate. Patients suffering from arthritis may experience significant relief after getting an injection. However, the pain may be from another source around the back or hip joint if it did not alleviate even after getting an injection. 

Impact of Pain on Lifestyle

Hip replacement surgery is generally recommended when arthritis can be clearly seen on an x-ray and causes significant pain. You should have a frank and candid discussion with the orthopedic surgeon regarding how the hip condition is affecting the overall quality of your life. 

You should also clear any concerns and doubts you may have. This will allow you to decide whether the surgery is good for you and when is the most suitable time to get it performed.

Board certified orthopedic surgeon Dr. Tigran Garabekyan of the Southern California Hip Institute (SCHI) receives patients from Los Angeles, Century City, Beverly Hills, CA, and nearby areas for orthopedic surgery.

Contact the Southern California Hip Institute

Dr. Tigran Garabekyan is a board certified orthopedic surgeon specializing in hip preservation. To learn more about Southern California Hip Institute or to schedule a consultation, click here to contact us or call:

Century City / Los Angeles: 310.574.0375

Serving patients in Los Angeles, Beverly Hills, Santa Monica, Century City, West Hollywood, North Hollywood Encino, Sherman Oaks, Van Nuys, Burbank, Glendale and other neighboring cities in the greater Los Angeles, California area.

Also visit http://www.drgorthopedics.com/

Patellofemoral Pain Syndrome (PFPS) 

Patellofemoral pain syndrome (PFPS) is a common condition that limits athletes. A growing body of evidence has gained popularity in recent years that suggests hip dysfunction to be a major contributing factor to PFPS.

Southern California Hip Institute (SCHI), led by board certified orthopedic surgeon Dr. Tigran Garabekyan, provides orthopedic surgery to patients in Los Angeles, Century City, Beverly Hills, CA, and surrounding locations.

PFPS and Hip Pain

Biomechanical and anatomic factors for PFPS have been interpreted through numerous studies. Clinical and research practice have recently reported an imbalance between the vastus medialis oblique (VMO) and the vastus lateralis (VO) to be the lead cause of increased lateral stress in the patellofemoral joint.

PFPS is also known to occur because of an abnormal patellar tracking. This is only secondary to an imbalance in the performance of quadriceps muscles. Nonoperative procedures are primarily focused on developing balance and strength in the VMO and other quadriceps muscles. While quadriceps exercise is the most prescribed intervention and it does result in a reduction in dysfunction and pain, it is not a complete resolution.

PFPS, in recent years, has also been related to deficits in core endurance and hip musculature. Patients with PFPS, as per biomechanical studies, demonstrate excessive hip adduction and internal rotation. Patients also have weak external rotators, hip abductors, and hip extensors as compared to patients that don’t have any pain.

According to a 2018 systemic review, knee and hip strengthening provides for effective and more superior results compared to knee strengthening on its own in patients with patellofemoral pain.

What is Patellar Malalignment?

Abnormal tracking of the kneecap in the trochlear groove may also be a cause for patellofemoral pain syndrome. The patella gets pushed to one side of the groove while bending the knee in this condition. This abnormality can result in increased pressure between the trochlea and the back of the patella, which may irritate soft tissues.

These are a few factors that can result in poor tracking of the kneecap:

• Alignment issues in the legs between the ankles and the hips: The kneecap may shift too far towards one side or ride too high within the trochlear groove because of alignment problems in a condition called patella alta.
• Muscular weakness or imbalance in the front of thigh: The quadriceps tendon and muscles work to keep the kneecap within the trochlear groove when the knee is used. You may experience poor tracking of the knee cap with imbalanced or weak quadriceps.

Diagnosis

Your doctor may check the following to help diagnose the cause of your pain and for ruling out any other physical concerns:

• Position of the kneecap
• Alignment of the lower leg
• Hip rotation, knee stability, and range of motion in the hips and knees
• Signs of tenderness in the kneecaps
• Thigh muscles attachment with the kneecap
• Flexibility, strength, tone, and firmness of the hips, hamstrings, and quadriceps

Imaging Studies

• Xray – Xray is required to rule out any damage to the bones
• MRI – This is ordered when the symptoms don’t improve with home exercise or physical therapy

Board certified orthopedic surgeon Dr. Tigran Garabekyan receives patients from Los Angeles, Century City, Beverly Hills, CA, and nearby areas for orthopedic surgery.

Contact the Southern California Hip Institute

Dr. Tigran Garabekyan is a board certified orthopedic surgeon specializing in hip preservation. To learn more about Southern California Hip Institute or to schedule a consultation, click here to contact us or call:

Century City / Los Angeles: 310.574.0375

Serving patients in Los Angeles, Beverly Hills, Santa Monica, Century City, West Hollywood, North Hollywood Encino, Sherman Oaks, Van Nuys, Burbank, Glendale and other neighboring cities in the greater Los Angeles, California area.

Also visit http://www.drgorthopedics.com/

Torn Labrum In Your Hip

Hip labral tear refers to an injury to the labrum. This is the soft tissue which covers the hip socket or acetabulum. This condition can be caused by degenerative issues, injury, and structural problems. Symptoms of hip labral tear include stiffness and pain in the hip. It can be treated non-surgically or with surgery.

Southern California Hip Institute (SCHI), led by board certified orthopedic surgeon Dr. Tigran Garabekyan, provides orthopedic surgery to patients in Los Angeles, Century City, Beverly Hills, CA, and surrounding communities.

Symptoms of Hip Labral Tear

• Pain in the buttocks or groin
• Hip stiffness or pain
• Locking or clicking sound from the hips
• A feeling of unsteadiness on your feet

Hip discomfort or pain can get worse if you have a hip labral tear when you rotate the hip, bend, play sports, or exercise. People can have this condition without any symptoms as well.

Hip Labral Tear Sensation

Torn labrum can feel different for different people. It depends on the severity and type of the tear. However, it is usually painful and uncomfortable. Labral tear pain is mostly near the groin, at the front of the hip. It can also extend all the way to the buttocks and thighs.

You may experience pain while squatting, rotating the leg, climbing stairs, or sitting for an extended period. Patients with labral tears describe the feeling as being unsteady when putting weight on the hip.

Diagnosing a Hip Labral Tear

The doctor will carry out a physical examination for diagnosing the hip labral tear. They may ask you to walk around or move your leg during the exam. The doctor can make a better diagnosis if you are honest about the pain you feel while moving.

Doctors can use imaging tests for diagnosing hip labral tear as well. They may order the following imaging tests for making a sound diagnosis:

1. X-rays

X-rays can alert physicians of any problems within the hip bones. This includes osteoarthritis and acetabulum (socket) of the hip. These conditions can contribute to a painful hip and labral tear.

2. Magnetic Resonance Imaging or MRI

The tests show soft tissues in the hip region in more detail. MRIs can be useful in showing where the labral tear is and the extent of its severity.

3. Diagnostic Injection

The doctor may choose to inject an anesthetic in your joint for diagnosing the cause of the hip pain. The doctor can determine whether the joint is the source of your pain by numbing the area. If pain is completely gone once you receive the injection, then the problem is in the joint. In case the problem persists even after receiving the injection, it could mean that something else is the issue.

4. Arthroscopy

This surgical procedure can be used for diagnosing and treating labral tears and other hip conditions. The doctor will insert a tiny camera in the joint to look for signs of damage. This will help in confirming the diagnosis.

Board certified orthopedic surgeon Dr. Tigran Garabekyan receives patients from Los Angeles, Century City, Beverly Hills, CA, and nearby areas for orthopedic surgery.

Contact the Southern California Hip Institute

Dr. Tigran Garabekyan is a board certified orthopedic surgeon specializing in hip preservation. To learn more about Southern California Hip Institute or to schedule a consultation, click here to contact us or call:

Century City / Los Angeles: 310.574.0375

Serving patients in Los Angeles, Beverly Hills, Santa Monica, Century City, West Hollywood, North Hollywood Encino, Sherman Oaks, Van Nuys, Burbank, Glendale and other neighboring cities in the greater Los Angeles, California area.

Also visit http://www.drgorthopedics.com/

Hip Pain in Women

Do you have pain in your hip? Women tend to experience hip pain more than men as with other types of chronic pain. However, there are several different causes of hip pain. It’s vital to find the right one for getting the best treatment.

An orthopedic surgeon will consider a female patient’s build, age, and level of activity when they come in complaining of pain in the hips. Possible causes of hip pain are different between a sedentary 80-year-old grandmother and a 20-year-old runner.

Southern California Hip Institute (SCHI), led by board certified orthopedic surgeon Dr. Tigran Garabekyan, provides orthopedic surgery to patients in Los Angeles, Century City, Beverly Hills, CA, and surrounding communities.

Hip Pain in Women – Major Causes

These are a few leading causes hip pain in women:

Arthritis

Chronic hip pain in women may be because of arthritis, in particular, osteoarthritis. This is the wear-and-tear kind of arthritis that affects a lot of people with age. Arthritis pain is caused because the ball-and-socket joint begins wearing out. It can be felt in the groin area or front of the thigh too because swelling and stiffness in the joint.

Hip Fracturs

These are common in older women with decreased bone density (osteoporosis). Pain while lifting, straightening, and standing on the leg is one of the symptoms. Toes on the injured side will also turn out.

Bursitis and Tendinitis

Bursitis is a common cause of hip pain in women. Bursae of fluid-filler sacs cushion the bony part of hip. These sacs can get inflamed because of overuse or irritation causing pain as you move the hip joint.

There are several tendons around the hip which connect muscles to the joint. These tendons can become inflamed in case you participate in strenuous activities or overuse them. Iliotibial band syndrome is a common cause of tendinitis at the hip joint, particularly in runners. This is a thick tissue spans that stretches from the outer pelvis to the knee.

Hernia

Hernia or sports hernia in the femoral, groin, and inguinal hernias can cause frontal hip pain in female patients. Inguinal hernias is more common in pregnant women because of the added pressure on their abdominal wall.

Back and Gynecological Issues

Hip pain in women can be because of gynecological issues. It’s crucial that women don’t assume their pain to be because of tendinitis, bursitis, or arthritis. The pain in the hip could be because of something else depending on your health issues and age.

Endometriosis

This is a condition in which the uterus lining tissue begins growing outside the uterus. It can create pelvic tenderness that may be described as hip pain by patients. In this condition, you will feel pain from the spine and back around the hip and buttocks too. You may suffer from sciatica as well that can cause pain in the hip or the back.

Sciatica refers to a pinched nerve that generally affects only one side of the body. Board certified orthopedic surgeon Dr. Tigran Garabekyan receives patients from Los Angeles, Century City, Beverly Hills, CA, and nearby areas for orthopedic surgery.

Contact the Southern California Hip Institute

Dr. Tigran Garabekyan is a board certified orthopedic surgeon specializing in hip preservation. To learn more about Southern California Hip Institute or to schedule a consultation, click here to contact us or call:

Century City / Los Angeles: 310.574.0375

Serving patients in Los Angeles, Beverly Hills, Santa Monica, Century City, West Hollywood, North Hollywood Encino, Sherman Oaks, Van Nuys, Burbank, Glendale and other neighboring cities in the greater Los Angeles, California area.

Also visit http://www.drgorthopedics.com/

Labral Tear 

Labral tears can occur on their own because of wear and tear or an acute injury. However, they commonly occur because of femoroacetabular impingement (FAI) – a type of underlying bone abnormality. The disorder is because of a structural abnormality in the hip bone joint. This can place the patient at risk of damage to labrum while performing certain activities, like cycling, running, soccer, jumping, gymnastics, and tennis.

Activities like this place the bones of the hip joint in compromised positions where the labrum can get crushed or become pinched resulting in repetitive damage.

Southern California Hip Institute (SCHI), led by board certified orthopedic surgeon Dr. Tigran Garabekyan, provides orthopedic surgery to patients in Los Angeles, Century City, Beverly Hills, CA, and surrounding locations.

What is Femoroacetabular Impingement?

FAI or femoroacetabular impingement is a condition in which the bones of the hip joint come too close and cause friction or pinch tissues. The femoral head or the ball of the hip joint usually sits on the femoral neck. This is similar to ice cream on a cone.

The friction and pinching take place when the femoral head and neck come in contact with the acetabulum or socket, damaging the hip joint. The friction or pinching can cause damage to the labrum. This is a fibrous cartilage which lines the outer edge of the socket and the articular cartilage.

FAI Symptoms

• There may not be any pain or symptom
• Aching or pain in the groin or inner hip area may occur after prolonged sitting or walking
• A clicking, locking, or catching sensation within the joint
• Pain after sitting for long time periods
• Difficulty putting on shoes and socks
• Difficulty walking up the hill
• Pain in lower back
• Pain in the greater trochanter (side of hip), buttocks, or SI (sacroiliac joint on back of pelvis)

FAI Surgery

FAI surgery can be performed as an open surgery or using hip arthroscopy. The hip is distracted in hip arthroscopy and a video-camera about the size of a pen (known as arthroscope) is used to look within the joint and treat any damage found. The entire procedure is completed by making just 2 to 5 incisions of ¼ inch in size.

Arthroscope can be used for treating all components of FAI, like damaged articular cartilage, labral tear, and bony changes between the socket and ball. Arthroscopic approach can be used for repairing a torn labrum and stimulating new cartilage growth through microfracture.

Hip arthroscopy that doesn’t involve bony decompression or labral debridement can be completed in less than an hour. Hip arthroscopy that involves cartilage or labral repair and FAI decompression generally takes about two hours. The surgery is performed as an outpatient procedure.

Open Surgery

Open surgical hip dislocation can be performed with a single long incision of 7 to 10 inches. It involves cutting the bone in the upper thigh and dislocating the ball from the socket to expose all joint parts. The exposure allows for treating the labral tear and any abnormal contact between the socket and the ball.

Southern California Hip Institute (SCHI), led by board certified orthopedic surgeon Dr. Tigran Garabekyan, receives patients from Los Angeles, Century City, Beverly Hills, CA, and nearby areas for orthopedic surgery.

Contact the Southern California Hip Institute

Dr. Tigran Garabekyan is a board certified orthopedic surgeon specializing in hip preservation. To learn more about Southern California Hip Institute or to schedule a consultation, click here to contact us or call:

Century City / Los Angeles: 310.574.0375

Serving patients in Los Angeles, Beverly Hills, Santa Monica, Century City, West Hollywood, North Hollywood Encino, Sherman Oaks, Van Nuys, Burbank, Glendale and other neighboring cities in the greater Los Angeles, California area.

Also visit http://www.drgorthopedics.com/