Author Archives: Tigran Garabekyan, M.D.

Osteoarthritis may be the cause of hip pain in many adults. However, hip pain in younger patients is usually due to a range of conditions, including birth deformities. Patients who need surgical treatment of hip dislocation have various surgical approaches available to them.

Technology Utilized

These approaches include hip arthroscopy, which is a minimally invasive surgical procedure (through tiny incisions) that uses miniaturized instruments and a tiny camera to view the treatment area.

Some patients (aged between 10 and 45 years) with more serious underlying conditions may be suitable candidates for surgical hip dislocation.

This open surgery enables the surgeon to view the joint and correct complex anatomical problems more easily. Surgical hip dislocation involves separating out the head or ball of the femur from its normal position in the acetabulum.

In comparison to hip dislocation occurring due to severe trauma or worsening of congenital deformity in the joint (where the dislocation is usually associated with injury to the surrounding blood vessels and muscles), surgical hip dislocation involves no harm to the surrounding muscles and preservation of the blood supply to the hip joint.

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.

Undergoing Surgical Hip Dislocation

Surgical hip dislocation can help address femoroacetabular impingement (FAI). In this condition, the femoral head meets the acetabulum in such a manner that the range of motion of the joint is restricted.

This condition may occur due to an underlying reason such as excess bone tissue on either the acetabulum or the femoral head and neck, or when the femur and/or acetabulum are positioned at an abnormal angle.

Other Types of Impingement with Complex Deformities

• Slipped capital femoral epiphysis (SCFE): This is a common hip condition among early teens. It occurs when the epiphysis (cartilage growth plate) at the top of the femoral head slips out of place.

The growth plate controls the way the top of the thighbone grows in children who have not yet attained skeletal maturity. In general, SCFE develops over a period of accelerated growth, shortly after the onset of adolescence.

• Perthes Disease: This condition is also known as Legg-Calvé-Perthes disease. It occurs due to idiopathic avascular necrosis of the femoral head. Perthes disease involves damage to the femoral head due to lack of blood supply.  It is typically detected in children in the age range of four to 12 years.

• Traumatic injuries with an osteochondral defect: This refers to a damaged region of bone and/or joint surface cartilage.

• The doctor may recommend surgical dislocation of the hip for patients who have unsuccessfully undergone hip arthroscopy or other surgical procedures previously.

• Tumors

Procedure

In this procedure, the surgeon separates and retracts a bone fragment from the upper part of the femur (greater trochanter) to gain access to the hip joint. This is a site of attachment for important muscles that surround the hip and enable it to move. This technique is known as a greater trochanteric osteotomy.

Through this approach, the surgeon is able to dislocate the hip safely. This procedure enables the preservation of the blood vessels surrounding the joint and leaves vital blood circulation and the surrounding muscles unaffected.

Prior to sealing the incision, the surgeon will use screws to hold the separated bone piece firmly in place to maintain stability during the healing process.

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

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

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

Developments in the area of arthroscopic surgical instruments and techniques now enable surgeons to use minimally invasive arthroscopic procedures to address conditions which would have required a more invasive, open surgery previously.

The Process

In hip arthroscopy, the surgeon places small incisions and uses these incisions to insert a camera (arthroscope) and related surgical instruments, if necessary.

In comparison to open surgical procedures, these tinier incisions and tools cause minor disturbance to the hip joint and related soft tissues. This is beneficial as it leads to:

• Less scarring and pain
• Reduced risk of infection and few complications
• Faster recovery

These benefits enable surgeons to preemptively address conditions that may lead to osteoarthritis. This preservative treatment helps delay the onset of hip arthritis as well as delay or eliminate the need for a hip replacement in the future. This concept is known as hip preservation.

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.

When Hip Arthroscopy is Recommended

In case the patient has a painful condition that is unresponsive to nonsurgical treatment, the doctor may recommend hip arthroscopy to them.

Hip arthroscopy may offer relief from the painful symptoms of many conditions that damage the articular cartilage, labrum, or other soft tissues around the joint. While this damage can be a consequence of injury, other orthopaedic issues may lead to these problems as well, such as:

Femoroacetabular impingement (FAI) refers to a disorder in which extra bone forms along the acetabulum (pincer impingement) or on the femoral head (cam impingement). This bone overgrowth, also known as spurs, causes damage to the soft tissues of the hip during motion. At times, bone spurs develop in the acetabulum as well as the femoral head.

Dysplasia is a condition in which the patient has an abnormally shallow hip socket. This exerts more pressure on the labrum to keep the femoral head inside the socket. The strain makes the labrum more prone to tearing.

In snapping hip syndromes, a tendon rubs across the outside of the joint. In general, this type of snapping or popping is usually harmless and does not require treatment. However, in certain cases, the tendon may sustain damage from the repetitive rubbing.

Synovitis leads to inflammation in the tissues surrounding the joint. Loose bodies are pieces of cartilage or bone that become dislodged and move around inside the joint.

Hip Joint Infection

Procedure

The surgeon will apply traction and make a small puncture in the patient’s hip (around a buttonhole’s size) for the arthroscope. They can view the inside of the hip and detect the damage through the arthroscope.

Through the arthroscope, fluid flows to ensure that the view is clear as well as to control the bleeding. The visuals from the arthroscope are projected on to a television screen giving the surgeon a view of the inside of the hip and any problems. Before starting any specific treatments, the surgeon will assess the joint.

After identifying the problem clearly, the surgeon will insert other tiny instruments through separate incisions to treat it. Depending on the patient’s needs, the surgeon can perform various procedures including:

• Trim bone spurs caused by FAI
• Smooth off damaged cartilage or repair it
• Eliminate inflamed synovial tissue

Tasks such as shaving, grasping, cutting, knot tying, and suture passing involve specialized instruments. The surgeon may also use special devices to anchor the sutures into the bone.

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

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

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

In the treatment of hip pain, nonsurgical treatment is always the initial course of action. Patients with hip conditions can experience a reduction or elimination of hip pain and inflammation with conservative treatments such as activity modification, rest, physical therapy, and/or anti-inflammatory drugs.

Corticosteroids injections are also commonly administered in case physical therapy, and anti-inflammatory drugs are not effective.

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.

Hip Arthroscopy

Arthroscopy is a minimally invasive surgery used to treat various hip conditions. During open surgery, this procedure enables a surgeon to access the hip joint through several tiny incisions instead of a large incision. This shortens the recovery duration.

All hip procedures are not performed arthroscopically. Every patient has different needs, and our surgeons work closely with patients to develop a detailed surgical plan to deliver excellent results.

The doctor may recommend hip arthroscopy for the following conditions:

• Labral Tears
• Hip impingement (femoroacetabular impingement)
• Removal of loose pieces of cartilage within the hip joint

Hip Arthroscopy Procedure

The surgeon will put the patient’s leg in traction after anesthesia. They will pull the hip away from the socket to create enough space to insert instruments, view the full joint, and perform the necessary procedures.

The surgeon will place two to five tiny incisions (each less than 1 cm in length) around the hip to insert the arthroscopy camera and required surgical tools. An x-ray machine will guide the instruments into the hip joint. Sterile saline water is used to irrigate and fill the joint space to view the inside more clearly.

The surgeon will assess the joint prior to starting any specific treatments. After identifying the problem clearly, they will insert other tiny instruments through separate incisions to repair it.

Surgical Hip Dislocation

Surgical hip dislocation is an open surgery which is used to treat more substantial deformities that arthroscopy cannot address in a safe or appropriate manner. The hip joint is deep and challenging to access through the many muscles and tissues surrounding and supporting it.

This procedure allows the surgeon to get a wider hip joint to undertake specific procedures such as femoral osteochondroplasty, labral repairs, and osteotomies. Surgical hip dislocation can help address the below mentioned hip conditions:

• Surface cartilage (articular cartilage) damage
• Labral tears (damage to the labrum, which acts like a cartilage cuff surrounding the hip socket)
• Femoroacetabular impingement deformities (Cam and Pincer Deformities)
• Femoral head fractures
• Perthes Deformities
• Dysplasia

Femoral and Periacetabular Osteotomy

Osteotomies can effectively treat the abnormal alignment of the hip joint and hip dysplasia. They are open surgical procedures that involve re-orienting either the femur or the (socket) acetabulum of the hip joint to realign and relieve pressure on the hip joint.

Post-Operative and Recovery

The patient will be given a written instruction sheet, images of their surgery, a prescription for therapy, and a copy of physical therapy (PT) guidelines when they are allowed to return home from the surgical facility.

A majority of patients should be able to walk with crutches right after the surgery with partial weight bearing (placing the foot flat on the ground as the patient walks). It is integral to undergo physical therapy to attain the best results. In some cases, physical therapy can start the day after surgery.

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

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

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

The primary objective of hip preservation is to prolong the hip’s lifespan and prevent the progression of arthritic damage to the joint, which may require an early hip replacement if left untreated.

Hip preservation enables the maintenance of the cartilage (lining of the joint) in good condition, prevention of arthritis, and a delay in hip replacement 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, CA, and surrounding locations.

Early Intervention

For the treatment of advanced arthritis of the hip, hip replacement is a common procedure. Degradation of the articular cartilage leading to arthritis may occur due to deformity, injury, and other hip conditions.

Early intervention to enhance the hip alignment and mechanics can decrease the arthritic damage to the hip, relieve pain, and delay, or at times, eliminate the requirement for hip replacement surgery.

The patient and doctor will decide if including hip preservation in the treatment plan is an appropriate option considering the patient’s age, activity level, the extent of articular cartilage damage, and other factors.

Patients aged 45 years or younger may be ideal candidates for hip preservation surgery. On the other hand, older patients with significant damage may be more suitable candidates for arthroplasty.

Hip Preservation Treatments

The first course of treatment for hip pain is always nonsurgical in nature. Conservative approaches such as activity modification, rest, physical therapy, and/or anti-inflammatory drugs are typically effective in the reduction or elimination of hip pain and inflammation for specific hip conditions.

The use of corticosteroids injections is also common in case physical therapy, and anti-inflammatory drugs do not alleviate the symptoms.

Hip Preservation Conditions

Labral Tears

Degeneration from osteoarthritis, structural abnormalities, trauma, injury, or repetitive movements can cause labral tears. The initial nonsurgical conservative treatment for pain relief in such cases involves anti-inflammatory drugs, physical therapy, and rest. If the pain from labral tears is unresponsive to conservative treatment, the patient may need surgery.

Hip Impingement

Hip impingement occurs due to bony abnormalities of the hip joint that lead to early contact between the socket and the ball of the joint.

The doctor may prescribe non-surgical treatment options such as anti-inflammatory drugs, activity modification, physical therapy, rest, and corticosteroid injections for pain relief. But these treatment options will not treat the underlying cause of the pain due to hip impingement.

Developmental Dysplasia of the Hip

Hip dysplasia refers to a condition in which the socket of the hip joint is misshapen or too shallow and does not completely support the ball of the hip joint.

Mild hip dysplasia can usually be addressed nonsurgically with activity modification, weight loss, corticosteroid injections, and physical therapy to relieve pain and pressure on the impacted hip.

Osteonecrosis

Osteonecrosis develops when portions of the bone tissue die because of insufficient blood supply, leading the bone to collapse. Osteonecrosis treatment depends on the site and severity of the damage.

While nonsurgical treatment may slow down the progression of this condition, a majority of patients with osteonecrosis will need surgery at some point.

Osteoarthritis

Osteoarthritis of the hip refers to the degeneration of the articular cartilage of the hip joint. In the early stages, osteoarthritis can be treated nonsurgically with anti-inflammatory drugs, activity modification, and physical therapy.

While hip preservation treatments differ from one another, they all seek to preserve the natural hip joint, limit the damage from osteoarthritis, and prevent or delay eventual hip replacement surgery.

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

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

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

Patients with recurring or chronic joint pain may feel that joint replacement surgery is their only option for relief. But there are various other less invasive options available today that can help them maintain mobility as they age.

Today, there are millions of baby boomers in the US who want to remain active well into their 60s, 70s, and beyond. Therefore, a significant amount of research in recent times has centered on joint health and replacement technology.

If a patient experiences joint pain, it does not automatically signal that they have to undergo joint replacement. In general, joint replacement surgery is performed for late stages of degenerative arthritis, also known as osteoarthritis, after other options have proven unsuccessful. Far less invasive treatments can help address most causes of hip pain.

So how does a patient decide whether their arthritis or other joint damage requires attention? If the patient experiences joint pain to the point that it hinders their activities for over three days without improvement, or they have repetitive pain in the same area over several weeks or months, they should consult a doctor.

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.

Surgery should only be a Last Resort

Most patients with joint causes for joint pain do not need surgery. But surgery is not the first choice even if the patient has osteoarthritis. Regardless of the cause, it is important to preserve the joints for as long as possible, and particularly so for younger and highly active individuals.

Joint replacement is now much safer and involves a faster recovery than before. The patient may go back home from the hospital on the same day or one day following the surgery. However, joint replacement is a serious operation and should not be taken lightly.

Today, joint replacement parts last longer in comparison to earlier parts. However, these parts are mechanical and may become loose, or stiff, or develop complications and infection. In such cases, the patient may require additional surgeries in the future.

A majority of individuals now live into their 80s. Many people of the next generation will live over 100 years. An active person in their 50s who undergoes hip joint or knee replacement may require one or two more surgeries in their lifetime. Therefore, the surgeon should try to avoid a surgical procedure until later as much as possible.  

Weighing the Options for Joint Preservation, despite Osteoarthritis

Factors

Age: Preservation techniques are usually more effective for younger patients.

Weight: The weight of the patient is proportional to the demand and pressure placed on a joint.

Muscle Strength and Conditioning: Muscles offer strength to the movement.

Severity: The doctor may, at times, treat small sites of cartilage thinning or erosion with procedures that are minimally invasive.

Location: The main focus of many joint preservation treatments is on the knees. However, a number of preservation therapies as alternatives to hip replacement are increasingly available as well.

The Advantages of Full Joint Replacement

It is vital to remember that joint replacement is a safe, proven and highly effective procedure for suitable patients who have been unresponsive to conservative treatment or if the damage to the bone or cartilage is beyond repair.

Patients should consult their doctors to understand the best options and long-term strategies for them. The basis for the best partnership for the patient should be the preservation of their joints as well as their activities and lifestyle.

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

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

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

Osteoarthritis (OA), also called degenerative joint disease or degenerative arthritis is the most frequently occurring chronic condition of the joints. It affects around 27 million people in the US.

OA can impact any joint, but it develops most often in the hips, lower back and neck, knees, the bases of the big toe and thumb, and the small joints of the fingers.  

Normal joints have a firm, rubbery material known as cartilage, which covers the end of every bone. Cartilage offers a smooth, gliding surface for joint movement and acts as a cushion between the bones.

Clear Negatives of OA

OA causes the cartilage to disintegrate leading to pain, inflammation, and issues in joint movement. This condition becomes worse over time causing the bones to break down and develop growth (spurs).

The final stages of OA involves the wearing away of the cartilage leading to bone rubbing against bone. This friction will cause joint damage and more pain.

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.

Who is Affected?

Osteoarthritis can develop in people of all groups, but it occurs most commonly in individuals over the age of 65 years. Increasing age, previous joint injury, obesity, weak thigh muscles, overuse of the joint, and genes are the common risk factors.

• One in two adults will develop knee OA symptoms in their lifetime.
• One in four adults will develop hip OA symptoms by the age of 85 years.
• One in 12 people 60 years or older have hand OA.

Treatments

Pain and Anti-inflammatory Drugs

OA medicines are available as syrups, pills, lotions or creams, or they are injected into a joint. These include:

Analgesics

Analgesics are pain relievers, and they include opioids (narcotics), acetaminophen, and atypical opioid known as tramadol. They are available OTC or by prescription.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

These are the most frequently used drugs to resolve swelling and associated pain. NSAIDs include ibuprofen, aspirin, celecoxib, and naproxen. They are available OTC or by prescription.

Corticosteroids

Corticosteroids are strong anti-inflammatory meds. They are either taken by mouth or injected directly into a joint by a doctor.

Hyaluronic Acid

Hyaluronic acid (HA) is a substance that occurs naturally in joint fluid. It acts as a lubricant and shock absorber. But HA seems to disintegrate in people with OA. The patient will receive HA injections at the doctor’s office.

Physical and Occupational Therapy

Physical and occupational therapists can offer a variety of treatment options for the management of pain, including:

• Ways to properly use joints
• Heat and cold therapies
• Range of motion and flexibility exercises
• Assistive devices
• Assistive Devices

Assistive devices can offer the patient help with mobility as well as function. These devices include canes, walkers, scooters, splints, and shoe orthotics as well as helpful tools such as long-handled shoe horns, jar openers, or steering wheel grips.

Many devices are available at medical supply stores and pharmacies. However, certain items, such as shoe wedges and custom knee braces are prescribed by a physician. A physical or occupational therapist usually fits these items.

Natural and Alternative Therapies

Many osteoarthritis patients use natural or alternative therapies for symptomatic relief or to enhance their general well-being. These therapies include acupuncture or acupressure, massage, nutritional supplements, and relaxation techniques and hydrotherapy.

Surgery

Joint surgery can replace or repair severely compromised joints, especially joints in the knees or hips. A doctor will refer a candidate for joint surgery to an orthopedic surgeon.

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

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

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

The chronic and often crippling pain of pelvic instability affects many women. This condition is believed to afflict a number of women, but it is not easily diagnosed.

However, now cutting-edge regenerative injection treatments such as PRP have been proven to be effective.

These therapies can provide sustainable pain relief by healing the damaged tissues that cause pain and instability. The patient should seek a pain specialist who has experience in diagnosing as well as treating this condition.

While it is challenging to diagnose, this condition can be successfully treated and potentially cured with a state-of-the-art new technique known as platelet-rich plasma (PRP) therapy. This regenerative injection therapy offers the patient relief from pain by restoring stability to the pelvic area.

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.

Promoting New Growth with PRP

PRP works in tandem with the natural healing process of the body to strengthen pelvic ligaments by promoting new growth. The patient will not need to undergo general anesthesia, hospitalization, or an extensive recovery with PRP therapy.

This non-pharmaceutical treatment can enable women to resume their active lifestyle and engage in activities such as skiing, jogging, or even horseback riding.

Non-invasive Procedure Offering Pain Relief and Healing

PRP therapy involves injecting highly concentrated platelets from the patient’s own blood into or near the damaged area. Platelets are vital in the recovery of injured tissues, broken bones, and wounds. In general, platelets account for six percent of the blood.

But patients undergoing PRP therapy receive an injection of their own highly concentrated platelets, which are as much as 95 percent concentrated.

A tiny amount of the patient’s own blood can enhance the process of healing and reduce pain due to conditions such as osteoarthritis in the shoulder, knee, spine, or hip. This can also treat ankle and ligament sprains, anterior cruciate ligament (ACL) injuries, tennis elbow, back and neck injuries, tendonitis, rotator cuff tears, and chronic plantar fasciitis.

Blood platelets contain hundreds of proteins known as “growth factors” which are crucial for healing wounds. Interestingly, one of the first responses of the body to a soft tissue injury is to direct platelet cells to the injured site to assist with repairs.

PRP injections use plasma with a much higher concentration of platelets than usually found in blood. This allows the concentration of growth factors to be five to ten times more (or richer) than in normal blood. Furthermore, there is no risk of transmissible infection as the patient’s own blood is used.

How PRP and Stem Cell Therapy Work

In PRP therapy, an amount of blood equivalent to nearly as much blood taken during a lab test is drawn from the patient. This is then spun at high speed in a centrifuge to separate the platelets within the blood.

These platelets are the cautiously and precisely injected into the compromised and painful body area. The patient may need many injections over several months.

According to some research studies, the patient may experience complete pain relief and healing within weeks following just one or two injections allowing them to resume normal activities at home or in their workplace.

The fact that PRP therapy enables healing in patients has been confirmed by magnetic resonance images (MRIs) and ultrasounds.

The early treatment of injuries before the damage increases and becomes irreversible enables patients to avoid surgery, anesthesia, and the risks associated with a surgical procedure. These innovative therapies may also eliminate the requirement for hospital stays, enable faster recovery, and allow the patient to return to work or sports faster.

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

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

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

A labrum tear, also known as a SLAP tear, refers to a tear to the ring of the cartilage around the shoulder’s socket.

Athletes engaging in sports that involve repetitive overhead or throwing motions, such as volleyball, baseball, and football, commonly experience this condition. Traumatic events such as a fall or age-related wear and tear can also cause labrum tears.

Southern California Hip Institute (SCHI), led by the accomplished board certified orthopedic surgeon Dr. Tigran Garabekyan, provides advanced treatments for the hip and shoulder joint to patients in Los Angeles, Century City, CA, and other towns and cities in this region of The Golden State.

Unique Labrum Tear Symptoms

It’s not fun for an athlete to view the same from the sidelines. The labrum tear symptoms to be watchful for are as follows:

Deep, Achy Pain

The pain typically occurs deep within the shoulder. Patients usually describe the discomfort as an ache rather than a stinging or nerve-type pain. The pain may be felt at the back of the shoulder. The patient may feel the pain in the front of the shoulder when the biceps tendon is involved.

Pain with Overhead Movements

Patients commonly experience pain during overhead motions, such as serving a tennis ball.

Popping, Clicking, or Grinding in the Shoulder

Some patients with this injury report a popping, clicking, and/or grinding sensation. The medical term for these symptoms is crepitus.

Shoulder Weakness

The shoulder may feel weak and as if it could “pop out” of its position. A labrum tear can make lifting weights overhead a challenge even if the patient is an experienced weightlifter.

A Decline in Sports Performance

The patient’s sports performance may be sub-optimal. For instance, a baseball pitched may notice reduced pitch speed.

They may also experience a feeling of instability in the shoulder, a decreases range of motion and strength loss. Patients with labrum tears also commonly experience pain at night or while performing routine activities.

Patients with a Bankart tear may feel as if the shoulder will slip out of its joint.

Labral tears typically occur along with other shoulder injuries such as rotator cuff injuries, dislocated shoulders, and biceps tendon tears. The doctor will examine the patient to determine which injury they have.

Diagnosing a Torn Shoulder Labrum

The doctor will check the patient’s range of arm/shoulder movement, stability, and pain level. The patient should inform the doctor of any event that may have led to the pain.

While the labrum tissue is too soft to show up in x-rays, the doctor may order an x-ray to check for other injuries that may be causing the pain. The doctor may order an MRI scan or CT scan to check for labrum damage.

Furthermore, the surgeon may perform an arthroscopic exam by inserting a small camera, known as an arthroscope, through a tiny incision. The camera will enable the doctor to view the labrum and any injuries to it clearly.

Causes and Risk Factors

Labrum tears occur due to traumatic injuries as well as wear and tear from repetitive movement of the upper arms.

Certain specific causes of labrum tears are as follows:

• A fall in an extended arm
• A direct hit to the shoulder
• A strong blow while the arm is overhead
• A sudden jerk to the arm

Prudent orthopedic surgeon Dr. Tigran Garabekyan receives patients from Los Angeles, Century City, CA, and other neighborhoods and communities in this region of the state for hip and shoulder joint treatments.

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

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

Platelet-rich plasma (PRP) has become an increasingly accepted procedure within the past decade in the orthopedic community as a technique to improve tissue healing.

The term platelet-rich plasma refers to any fraction of autologous blood comprising a higher concentration of platelets relative to the baseline

In recent times, PRP has been used for various musculoskeletal conditions such as patellar tendinopathy, rotator cuff repair, lateral epicondylitis, knee osteoarthritis, and osteochondral lesions of the talus among others.

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.

Healing Effects of PRP

PRP brings about musculoskeletal healing in multiple ways. PRP improves the mobilization of circulation-derived cells as a treatment modality for tendon healing.

This mobilization may include inflammatory cells that release growth factors and cytokines, and fibroblast-like cells that synthesize matrix. In comparison to serum, PRP has been proven to substantially enhance the deposition of collagen-rich extracellular matrix, with a higher level of collagen in comparison to placebo.

Notably, research has shown that PRP-treated tendon tears actually comprise fewer blood vessels in comparison to placebo, potentially indicating a more physiological process of healing.

The Role of Growth Factors

Compared to whole blood, PRP consists of higher concentrations of specific growth factors. Therefore, PRP may be able to replace hematoma with a higher concentration of growth factors and platelets to enhance healing. In addition, PRP has been proven to encourage angiogenesis through activation of PRP-releasate.

PRP may be used as a conservative treatment or as adjunctive therapy during surgery, depending on the pathology. PRP may be able to improve upon tendinopathic changes or partial tendon tears in which the tendon ends are not retracted when used as conservative treatment.  

PRP injections are used most often as adjunct conservative treatment. For chronic tendinopathy or osteoarthritis patients, PRP is usually recommended when first-line treatment (rest, physical therapy) is ineffective.  

Professional athletes may benefit from in-season PRP to mitigate pain and enhance function as an interim treatment until offseason when they can undergo a surgical procedure. In the case of hip labral tears and chronic tendinopathies, this is especially true.

PRP injections can help enhance healing when there is tendinosis without retraction or partial thickness involvement. Surgical repair is the best treatment for complete tears, especially if these tears are retracted and chronic.

Hip Osteoarthritis, Acute Inflammation, and Labral Tears

The conservative treatment of osteoarthritis (OA) of the hip joint usually involves hyaluronic acid (HA) or intra-articular injections of corticosteroids.

But PRP has shown promising results in the reduction of early-stage OA symptoms more successfully than HA. While there is limited availability of research on the effectiveness of PRP on hip OA, the concept and mechanism of action are the same as in the case of knee OA.

PRP injections are effective in cases of OA as well as for professional athletes who have acute hip inflammation because of intra-articular pathology.

In such cases, PRP addresses the symptoms of inflammation and allows the athlete to quickly return to play without the potential adverse effects of steroids.  

Key Points

Some innovative and established applications of PRP are available for the treatment of hip and pelvic pathologies. While the results of many of these applications have not been elaborated by researchers, the experience of doctors indicates that symptomatic and functional results are successful in most patients.

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

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

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