Hip-sparing surgery and its purpose

Hip-sparing surgery means taking the necessary precautions in a timely manner, preventing complete calcification of the hip and protecting it from prosthetic surgery.

It is possible to benefit from hip-sparing surgery in every age group, from children to adults. On the other hand, although it is not certain, there is a 45 age limit. Scientific publications on the subject state that the chance of success in hip conserving surgeries after the age of 45 decreases. However, it should not be forgotten that sometimes the bone quality of a 50-year-old person may be 40 years old, and the bone quality of a 40-year-old person may be 50 years old. Therefore, the age limit of 45 is a relative situation. However, the chance of success increases when applied to those under the age of 45. It is not recommended after the age of 60.

Situations in which Hip Conserving Surgery is Applied

The hip joint is a ball socket joint. The head of the bone is in the form of a round ball, and the slot is in the form of a hole suitable for this ball and works with zero error. In some cases, the fact that the socket is deeper than normal or completely round, and there is a bump or protrusion in any part of the head, causes the hips to rub while working over the years and these regions to wear out each other. In addition, if the bone is not perfectly round, that is, if there is a structural problem from childhood, it does not show any symptoms because the cartilage is very thick at the beginning; Years later, when the adult comes to age, pain occurs due to the friction of the hip and problems with walking can be seen. In such cases, hip-sparing surgery is applied as an early treatment for problems caused by incompatibility of the socket.

Complaints Seen in Patients

Patients often experience hip pain. The pain is described by patients as a groin pain radiating towards the knee. Since the pain is in the groin, women primarily tend to branches such as obstetrics and urology. In some cases, patients may go to the doctor with the complaint of low back pain. Since low back pain can be confused with gynecological diseases and urinary tract infections, a differential diagnosis should be made first. Radiological examination should be performed to make the diagnosis. A 90 percent diagnosis can be made with plain X-rays taken at different positions and measured.

While planning the treatment, MRI, three-dimensional tomography and other examinations may be needed. However, it should not be thought that every radiological problem will be treated. It is necessary to wait and see if the patient has a complaint of pain. In some cases, although there are radiological problems in 70-80 years old people, it is seen that there is no complete calcification and the patient does not have pain complaints. However, if there is pain and the diagnosis has been made, treatment should be started without delay in order to prevent complete calcification of the hip.

Hip Conserving Surgeries and Hip Arthroscopy

There are two types of treatment for problems such as hip compression or incompatibility, open and closed surgery. Open surgery is also divided into two as large open and mini open. As the name suggests, open surgery is performed by opening the hip joint and treating the problem. Sometimes, if the problem is smaller and localized to a certain area, a five- to six-centimeter incision is made and treated, which is called “mini open”.

The application of arthroscopy, which is called closed surgery, has gained momentum especially in the last 10 years. It can be applied to both children and adults. Hip arthroscopy is the imaging of the joint by entering the camera and other auxiliary tools through very small incisions, and the treatment of diseases related to the joint. Today, it can be applied to almost any hip-related problem, but it has limits.

Unlike other joints, special angle cameras are used because the hip is deep and the space for the placement and movement of the instruments is very narrow. Thus, the entire hip can be viewed to a large extent. However, if the hip is too deep and calcified, it cannot be entered between the joints with the camera. Apart from this, it is possible to benefit from arthroscopy at a rate of 90%.

Conditions in which Arthroscopy should not be applied

If it is thought that there is an active infection in the hip, it should be done carefully in this group. If the hip is in a state called “adhesive”, as if the adhesive was squeezed in, the hip cannot be opened and it can be harmful when entered with the camera. In these cases, arthroscopy is not performed because it is necessary not to force it.

On the other hand, a special rehabilitation program should be applied after arthroscopy. Patients are warned about the movements that should not be done. The hospital stay is usually one day. If the person to whom the application is made is an active athlete, he can continue to do sports after 3 months. In some cases, this period may take up to 6 months.

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