More Than Just The Hip
The spine, pelvis, and hips form an integrated kinetic chain. As such, each of these elements has to be included in the evaluation to properly diagnose and treat disorders that give rise to hip pain. Failing to do so will result in incomplete relief of symptoms and recurrence of the condition. At SCHI, every patient with a hip problem undergoes a comprehensive evaluation of the lumbar spine and pelvis, in addition to both hips. Gait analysis, neurologic function, range-of-motion, and muscle strength are tested on both sides of the body and compared. Tendon insertions are evaluated for degeneration or tearing. Core strength and gluteus activation are evaluated for proper pelvic balance. All of these findings are integrated with the patient’s history to arrive at a comprehensive diagnosis and plan of care. We know that getting you back to your active lifestyle takes more than a five-minute visit and we invite you to experience the SCHI difference.
Adolescence to Late Adulthood
There are many physicians in the region who perform hip replacement surgery. However, few perform hip arthroscopy and an even smaller number carry out complex realignment procedures of the pelvis and upper femur. Given the difficulty of accurately diagnosing hip problems, patients often visit three or more physicians before finding one who can address their problem. There is a better way.
SCHI is the one-stop-shop for your hip. Dr. Garabekyan is fellowship trained to address ALL complex hip disorders afflicting patients from adolescence to late adulthood. You no longer have to waste time and money going from one doctor to another, only to be told that the source of your pain is unclear or that joint replacement is the only option. By entrusting your health to a team that specializes in treating the full spectrum of hip disorders, you can rest assured that your treatment will be customized to your specific goals. No two patients are the same, and no two treatments are identical. Let us explore the different options together and show you the path to a pain-free and more active lifestyle.
Cutting Edge Techniques
Surgical techniques continue to evolve and as a result patients can enjoy shorter recovery times than ever before. Dr. Garabekyan employs the latest techniques in minimally invasive surgery that dramatically reduce your risk of complications and get you back to life faster.
- Hip Arthroscopy Without a Post
Hip arthroscopy is typically carried out by using an operating table with the patient’s legs strapped in specialized boots to apply traction and create working space in an otherwise tight hip joint. In order to prevent the patient from being pulled down the table, a counterforce is used in the form of a large padded post placed in the perineum (between the legs). Despite efforts to reduce the traction force and duration, horrible complications have been reported in the literature including genital numbness and tissue necrosis. Some patients are left with permanent sexual dysfunction requiring additional urologic treatment, a devastating complication for a young male or female undergoing an elective, outpatient procedure. Dr. Garabekyan utilizes a safer technique for counter-traction without a post, removing all pressure form the perineum. Traction forces are lower than the conventional technique and patients can rest assured that they will not be dealing with a life altering complication.
Figure 1 – Traditional technique for hip distraction with use of a perineal post places the significant pressure in the groin potentially leading to genital numbness and tissue necrosis.
Figure 2 – Intraoperative set-up for a patient undergoing right hip arthroscopy without a perineal post. The patient previously underwent left hip arthroscopy through two small keyhole incisions with an excellent result.
- Simultaneous Bilateral Hip Arthroscopy
Hip disorders frequently present in both hips with one side being slightly more involved than the other. For patients who have significant hip disease on both sides, many surgeons offering hip arthroscopy will recommend doing one side, waiting 3 months, and then undergoing surgery for the other side. This staged approach is largely due to concern for prolonged traction time and pressure on the perineum. For the patient, it means a much longer overall recovery time, two episodes of anesthesia, and increased cost associated with two hospital charges. Dr. Garabekyan offers simultaneous bilateral hip arthroscopy for patients suffering from problems in both hips to address these shortcomings. Studies have shown that patients on average feel no more pain than if they had undergone surgery for one side alone (unilateral surgery) and their overall time to return to activities is comparable to unilateral surgery as well.
The SCHI advantage is all about you. From the moment you walk into our clinic to the moment you look back on the journey that gave you your life back, you will feel like the whole process was designed just for you. And that’s because it was.
