New procedure for hip pain

February 21, 2008 8:00:59 PM PST
If you suffer from chronic hip pain, you might be suffering from an under-recognized, under-reported condition. Patients often find even walking can cause persistent pain, but now a Bay Area doctor is using a minimally invasive procedure to treat it.

Nurse Annette Corbolotti is having hip surgery because she can no longer stand the pain.

"Progressively over the last six months there's a catching sensation in my hip, and with that, accompanies it, sharp pain," says Corbolotti.

"The biggest problem is when she flexes up her hip, her thigh bone and her cup are pinching against each other causing the damage in her hip. And we think this is why people get arthritis," says Mark Lawler, M.D., an orthopedic surgeon.

"The catching became progressively worse and rather than having it just once or twice a day it was all day long and really inhibited my activity," says Corbolotti.

"The technology is really getting a lot better as time goes on," says Dr. Lawler.

It's called impingement syndrome, and until recently, it was rarely diagnosed or treated.

"The average person comes into my office and has been having these problems for years, even decades," says Dr. Lawler.

With impingement syndrome, every time a patient takes a step, the femur rubs on the hip socket. That can cause torn ligaments and bone spurs. But until recently, it wasn't really treated. Instead, patients were told to wait until the pain was unbearable to then have a hip replacement.

"It's a very emerging technology in orthopedics right now, but it's done by very few people," says Dr. Lawler.

Marin orthopedic surgeon Dr. Lawler is performing minimally invasive hip arthroscopy on Annette, but the nature of her impingement makes the surgery more difficult.

"The current procedure that we're doing is kind of state of the art. It's emerging as we speak. It's changing about every three to six months on what we're doing," says Dr. Lawler.

He begins by cleaning up all the debris around her torn ligament. At the same time, he starts eliminating bone spurs. He then reattaches the torn ligament and finally shaves down her hip socket cup to restore movement to the ball and socket joint.

"We're going to remove bone on the neck of her femur. We're probably going to remove bone on the cup of her hip so when she flexes up her hip clears and by doing that we're actually going to try to preserve her hip and try to avoid a replacement," says Dr. Lawler.

It's a surgery that's worked well for other patients of Dr. Lawler.

Firefighter paramedic Dan Loughran suffered two years of undiagnosed pain before Dr. Lawler operated on him.

"The pain level, and they always want you to put it on a one to ten, [was] a constant seven with electric shock, burning in my thigh, radiating out of my back," says Loughran.

Before surgery, Loughran could barely move. Now three months after hip impingement surgery, he's well on his way to recovery.

"At the worst before surgery there was no way I could get on even a stationary bike because the pain was too much," says Loughran.

But now...

"I'm able to ride it, and I ride it for at least 20 to 30 minutes without having any serious pain," says Loughran. "Now it's like much better. So yeah, I'm glad I did it."

So if you have hip pain and have been told there's nothing to be done but hip replacement, this could be an option.

Until recently, doctors performed open hip surgery if they treated hip impingement surgery at all. It required longer recovering time and caused greater pain. This new minimally-invasive procedure has only recently gained acceptance.

Physician profiled:
Mark Lawler,M.D.
Marin Orthopedics and Sports Medicine
4000 Civic Center Dr # 205
San Rafael, CA 94903
(415) 492-1600

Surgery performed:
Novato Community Hospital
180 Rowland Way
Novato, CA 94945
(415) 209-1300