Published on 20. June 2015

Alternatives to joint replacement – minimally invasive treatment of hip pain

Pain or restricted mobility in the hip is one of the most common reasons why patients visit an orthopedist. In around 220,000 cases per year, hip complaints in Germany lead to the implantation of an artificial hip joint. What many patients do not know: There is a whole spectrum of joint-preserving treatment methods.

Effective relief from hip pain

If joint-preserving therapies are started in good time, a wide range of complaints can be effectively alleviated with the help of gentle minimally invasive procedures. Implantation of an artificial hip joint (hip endoprosthesis) is then often no longer necessary at all or necessary but much later.

Alexander Moser, MD, is head of hip surgery and the Center for Endoprosthetics at Vivantes Friedrichshain Hospital. The center is one of the few clinics in Berlin to offer the entire spectrum of hip surgery – from gentle minimally invasive surgery and conversion operations to artificial joint replacement.

Arthroscopy of the hip as a routine procedure

A special focus of the clinic is joint-preserving surgery. Hip arthroscopy, or arthroscopy of the joint, is a method that can be used to treat many diseases of the hip. "Arthroscopy of the hip requires a particularly high level of experience on the part of the treating physician," explains Dr. Moser, who himself has specialized in joint-preserving therapies for more than eight years. "This is because the hip joint, unlike the knee or shoulder, is very difficult to access. Only in specialized centers like ours in Friedrichshain a doctor can gain enough experience to safely apply the method." During arthroscopy, the surgeon guides the fine instruments through two approximately two-centimeter-long incisions to the joint. The muscle tissue of the hip remains unharmed. With the help of a camera, possible damage is determined and treated in the same step. Vivantes Friedrichshain Hospital is one of the few clinics in Germany to offer arthroscopy as a routine procedure.

Treating pain early means avoiding joint replacement

It often takes a long time for a patient to find a specialist. In this case, early treatment is crucial to preserve the joint as long as possible. Causes of the complaints are often bony changes (femoroacetabular impingement), injuries to the joint lip (labrum rupture) or hip arthrosis (coxarthrosis). Congenital or acquired deformities such as hip dysplasia also cause pain over time. "The typical hip pain manifests in the groin and is misinterpreted as a groin pain," explains the hip specialist. "For this reason, the treating physician needs a lot of experience to determine the cause of the discomfort. By offering the full range of treatment methods at our center, we can quickly make a reliable diagnosis and decide individually which therapy is best for the patient."

If the hip is already too badly damaged, an endoprosthesis is inevitable. But especially for young patients, the early use of an artificial joint is not problem-free. After about 15 to 20 years, the joint wears out and has to be replaced. With such a replacement operation, the risk of complications is significantly higher than with initial implantation. "This is precisely why it is so important to start minimally invasive treatment at an early stage," emphasizes Dr. Moser. "This often allows us to prevent a chronic course of the disease, alleviate symptoms and avoid artificial joint replacement."

 
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