Author Archives: Tigran Garabekyan, M.D.

Labral Tear 

Hip labral tear occurs when the band of cartilage surrounding the hip joint, called the labrum gets injured. The injuries can occur because of trauma, such as a car accident or fall. However, they can also occur because of repetitive stress to the hip joint.

Individuals participating in soccer, hockey, and long distance running among other sports requiring extremes of motion are often diagnosed with labral tears. This involves activities that require sharp movements and repetitive twisting.

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.

Preventing Labral Tears

Risk of sustaining a labral injury is enhanced with repetitive motions, such as long-distance running or sports. It is important to be aware of hip pain, especially while squatting or sitting. These can indicate signs of potential hip injuries.

Identifying and addressing the injuries early in the treatment can be helpful. Physical therapists can help active individuals identify proper body movements for lessening the possibility of injury. You need to continue muscle strengthening practices and lower-extremity mobility after recovering from a hip labral tear.

This will play a major role in reducing the risk of further injury or irritation. Complete avoidance of the activity contributing to the symptoms may be suggested in some extreme cases.

Procedure of Hip Labral Tear Repair Surgery

Your doctor may perform the following during a surgery:

• Labral tear repair: The torn labrum will be reattached by the doctor to the socket (acetabulum) by using sterile thread and small plastic anchors
• Debridement: The doctor may trim or smooth the area of the frayed labrum. The goal is to remove any damaged, loose, or pain-generating tissue.
• Other repairs: Hip problems are generally intertwined. Hence, it is common for surgeons to repair the hip labrum and address any other problem during the surgery. For instance, your surgeon may decide to shave any bony abnormalities causing hip impingement while repairing the labrum.

The decision of carrying out repairs may be made during the surgery. Everything wrong with a joint cannot be revealed during the pre-operative medical imaging. Your surgeon may discover or confirm other hip problems during the surgery.

Open Hip Surgery vs. Arthroscopic

Hip labral repair surgery can be performed using open surgical methods or arthroscopic methods. Hip arthroscopy is minimally invasive using special tools and a video camera. Larger incision of 8 – 10 cm is required in open hip surgery. The surgeon may dislocate the joint’s femoral head from the hip socket.

Labral Tear Reconstruction

Graft tissue from some other body part is used during labral reconstruction using graft. This completely replaces the torn labrum and the procedure is performed where the labrum is too damaged but the hip joint is healthy. The severity of your injury will determine the type of surgery that is recommended. Underlying conditions that need to be addressed will also determine the type of surgery performed.

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: 310.595.1030

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 

Acetabular labral tear causes pain if the labrum is frayed, torn, or damaged. Labral tears can result in pain in the anterior side of the hip, groin pain, and buttock pain. This condition is thought to result from excessive force at the hip joint.

For instance, a tear may decrease the acetabular contact area increasing stress. This may destabilize the hip joint by causing articular damage. Labral tears can be classified as:

• Posterior labral tears: these are situated deep in the posterior buttocks or in the lateral region.
• Anterior labral tears: the pain may become more consistent in this type of tear. It is situated at the groin, anterosuperior quadrant, or on the anterior hip. These are more common in United States individuals.

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.

Clinically Relevant Anatomy

The acetabular labrum comprises of the fibro-cartilaginous rim. This encompasses the circumference of the acetabulum and helps in keeping the femoral bone’s head inside the acetabulum. The labrum differs widely in form and thickness.

There are three surfaces to the labrum:

• Internal articular surface is adjacent to the joint
• External articular surface is in contact with the joint capsule
• Basal surface is attached to the acetabular ligaments and bone

The labrum is triangular in the radial section on the anterior aspect. It is dimensionally square with a rounded distal surface on the posterior aspect.

Various functions of the acetabular labrum include:

• Sensitive shock absorber
• Joint lubricator
• Pressure distributor
• Joint stability
• Decreasing contact stress between the femoral and acetabular cartilage

Epidemiology/Etiology

Labral tear injuries are attributed to several causes by researchers studying patients:

• Direct trauma includes falling with or without dislocation, slipping, and motor accidents among others
• Sporting activities requiring hyperextension or frequent external rotations, such as soccer, ballet, running, hockey, and sprinting
• Specific movements include twisting movements, torsional movements, hyperextension, hyper abduction, and hyperextension with lateral rotation

This is not an age-related condition and can occur in anyone from 8 – 75 years of age.

Arthroscopy

Acetabular labral lesion repair can be performed in both lateral and supine position. A stand fracture table is used when patients are treated in the supine position. Traction is applied by keeping the patients in an oversized perinal post.

The affected hip will be slightly extended to approach the joint. There should be minimized pressure on the perineal area during traction for avoiding neurological complication. The procedure is performed under the guidance of fluoroscopy.

Tear edges are delineated and suture anchors placed on the acetabular rim for repairing a detached labrum. A suture is placed in the mid-substance of the tear if the labrum tear has a secure outer rim. This suture is placed in cases where the labrum is still attached to the acetabulum. It is done for securing the tear.

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: 310.595.1030

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 Problems

Hip problems are a common concern for several patients because of the involved pain. This is particularly true for aging people that maintain an active lifestyle. The specific location of pain can help towards pinpointing the underlying cause. There can be issues with the muscles, tendons, ligaments, and soft tissues surrounding the joint.

There may be issues in the spine and lower back as well. Hip pain can be felt in the groin, outer hip and upper thigh. Southern California Hip Institute (SCHI), led by board certified orthopedic surgeon Dr. Tigran Garabekyan provides orthopedic surgery to patients in Los Angeles, Century City, CA, and surrounding communities.

Common Early Symptoms of Hip Problems

1. Groin or Hip Pain

The pain is generally located between the knee and the hip. Hip pain can be felt during sleeping, exercising, and walking. It can result in loss of motion in the hip. Soreness and discomfort during or after exercising is one of the earliest signs of hip troubles. Hip issues can cause sleep problems as your natural movement at night may be hampered. You should immediately see a specialist if your hip pain prevents you from walking comfortably.

2. Stiffness in the Hip

Stiffness in the hip may not allow you to put on your socks and shoes comfortably. You may have trouble bending down or picking up something.

3. Limping When You Walk

Limping while walking can be a serious symptom of hip troubles. This can be chronic or acute. It should be treated with proper medical care by an orthopedist.

4. Tenderness and Swelling in the Hip

Swelling and tenderness is another sign of hip troubles. Swelling can take place in the outer skin and muscle or internally. You should contact your doctor if the swelling doesn’t go away or becomes unbearable.

The symptoms can differ among different people. Hip pain can result in disability if it is not treated. This is why you should get in touch with a committed physician specializing in hip and other joints.

Choosing an Orthopedic Surgeon for Safe and Effective Hip Strain Treatment

Your hip pain can be quickly evaluated by experienced and skilled orthopedic surgeons to determine the root cause. They know the most effective treatments for decreasing pain and correcting the problem. It’s crucial that you always aim for the least expensive procedure for providing relief from hip pain.

A team of physical and occupational therapists may be recommended by the surgeon. They will teach you some strengthening exercises to increase movement by making the hip muscles stronger. This will prevent your hip muscles from overstressing. The team will also give you tips to keep your hips along with other joints in good condition.

It’s vital that you don’t delay seeking treatment if you have pain due to arthritis or any other condition in your hips. It is best to work with a skilled and accomplished orthopedic doctor that specializes in joint pain, especially hip joint.

Board certified orthopedic surgeon Dr. Tigran Garabekyan receives patients from Los Angeles, Century City, 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: 310.595.1030

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 Flexor Strain

Hip flexors are a group of flexible muscle tissues that allow you to bend knees and flex your hips. These are located in the pelvic region and near the top of the thigh. Overstretching or overusing these muscles can cause strain. This can significantly limit your mobility and activity.

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

Hip Flexor Strain Injury

Typically, this orthopedic injury occurs when the hip flexor tendons and muscles are used too much. This causes excessive stretching and tearing. Hip flexor strain can be categorized into three grades depending on the extent of severity:

• Grade I tear is a minor tear that involves a few damaged fibers. Your hip will function normally.
• Grade II tear involves damage to several muscle fibers. You may experience moderate loss of function. Your hip may give out sometimes while walking or standing.
• Grade III tear involves completely torn muscles. Your hip won’t be able to bear your weight.

Symptoms of Strain in the Hip Flexors

The primary symptom of hip flexor strain is pain in region where the thigh meets the hip. There are several other symptoms associated with this condition:

• Cramping in the upper leg muscles
• Sharp pain the pelvis or hip
• Tender or sore upper leg
• Difficulty in sprinting, jumping or kicking
• Tugging sensation in the groin area
• Stiffness or tightness after being still
• Tenderness or pain when walking stairs

Sports related accidents a primary cause of strain in the hip flexors. However, other factors, such as poor posture, overuse, poor walking habits, and arthritis can cause this condition as well.

Hip specialists will examine your upper leg area to diagnose the condition. They will create a treatment plan after discussing the symptoms and related activity.

Treatment of Hip Flexor Strain

You can treat most hip flexor injuries at home. They don’t require invasive procedures or prescription medications. You may be asked to ice the area by your doctor. You would also be asked to avoid actions that make you overuse the hip flexors. Gentle stretching can greatly help in reducing muscle tension and decrease the risk of future injuries.

Your hip specialist will advise physic therapy if the injury is because of a larger muscle tear. On occasions, surgery for repairing the ruptured muscle may also be recommended. Most of the time, the recovery time depends on the severity of the injury. It may take a few days for mild strains to heal. Severe strains may need up to 6 weeks for complete recovery. You can worsen the injury or suffer greater pain if you fail to rest.

Your day can be brought to a grinding halt because of nagging hip pain. You can regain mobility by working with a proven and experienced hip specialist. The right treatment provider can get you on the road to recovery quickly.

Board certified orthopedic surgeon Dr. Tigran Garabekyan receives patien

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: 310.595.1030

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/ts from Los Angeles, Century City, CA, and nearby areas for orthopedic surgery.