Orthopedic Surgery News Archive Featured in the Media JeffNEWS

Javad Parvizi, M.D., joint specialist at the Rothman Institute at Thomas Jefferson University Hospital, is the sole orthopaedic surgeon in the Philadelphia region and one of only about a dozen in the United States performing two new innovative procedures that preserve a patient’s native hip joint, rather than replace or resurface it.  The surgery is used to treat the pain and loss of mobility associated with hip dysplasia and impingement (femoral acetabular impingement) in younger individuals.

“Prior to preservation techniques, patients as young as 14 had no options but to try medications like non-steroidal anti-inflammatory drugs (NSAIDs), or to have a replacement or resurfacing procedure,” says Dr. Parvizi, who is also associate professor of Orthopaedic Surgery at Jefferson Medical College, Thomas Jefferson University. 

“A replacement is basically cutting the joint and throwing it away, so if five or 10 years from now we develop a way to restore or substitute cartilage, or discover other forms of treatment, replacement patients will not be candidates,” adds Dr. Parvizi. “Preservation is a win-win for younger, qualified patients, not only because it reduces pain and restores mobility, but also because it allows for a wide range of future options if arthritis progresses down the road.” 

These options include both hip resurfacing and total hip replacement because the patient comes out of surgery with their own anatomy intact.  Unlike hip replacement or hip resurfacing, hip preservation does not require implants or devices to be positioned in place of the natural joint. 

There are two types of hip preserving procedures.  The first, a periacetabular osteotomy, is used for patients with hip dysplasia, a condition where the head of the femur (the thigh bone) only loosely or partially fits into the acetabulum (concave socket in the pelvis) and the femoral head or acetabulum is misshapen, causing abnormal wear and tear within the joint as it moves.  Hip dysplasia is caused by a combination of genetic and environmental factors and is one of the leading causes of degenerative arthritis.  As the more complicated of the two procedures, the periacetabular osteotomy usually involves making several cuts in the pelvis to realign the angle of the acetabulum so that the femoral head can fit properly into place.  It may also involve smoothing of a misshapen femoral head to eliminate the friction caused by its movement.  Recovery takes up to three months.

The second surgery is a femoroacetabular osteoplasty.  It was developed by Dr. Parvizi and is used for patients with hip impingement, a disorder becoming more recognized as a cause of hip pain in active adults and a previously unrecognized cause of arthritis in young adults.  Impingement is caused by a lack of room between the neck of the femur and the rim of the acetabulum, causing the neck and rim to jam together as the hip is flexed (as in sitting or running).  This jamming leads to pain manifested in the hip or groin region and may lead to early degenerative arthritis of the hip.  The procedure itself focuses on smoothing the surface in the space between the neck and the head of the femur.  It takes about six weeks to recover.

Eligible patients should be under 50 years of age.  If arthritis is already present, it must not have progressed past stage three. 

Though the preservation procedures can be more technically difficult, there are clear benefits to keeping your own joint, says Dr. Parvizi.  “Patients can go back to regular activities without limitations and there is less risk of post-operative infection than with replacement surgery.  Additionally, there is little to no risk of the joint dislocating.”

For more information, call 1-800-JEFF-NOW or visit www.JeffersonHospital.org