Doctors use a new procedure in patients with damaged hips to avoid replacement surgery

December 18, 2017
Doctors at Wexner Medical Center in Ohio State University use a procedure called subchondroplasty to give patients with damaged hips more treatment options and ultimately avoid replacement surgery.
"We want to preserve the hip if possible, because once you have a hip replacement, there is no return," said Dr. Kelton Vasileff, an orthopedic surgeon at the hospital. Ohio State Wexner Medical Center. "We are able to use a hardening bone procedure that is traditionally used in knee surgery to help repair the hip joint of a patient."
During the procedure, a bone substitute material is injected into a small hole in the joint, filling the voids or lesions in the bone. In the few years after surgery, a patient's body replaces the bone hardening material with its own healthy bone, which leads to what Vasileff hopes to be permanent repairs.
"In the past, a replacement would be the only long-term option for many patients, but this procedure allows me to add support to the bone, making more damage-reversing surgeries possible," said Vasileff, who specializes in hip preservation surgery.
Every year, more than 300,000 Americans receive a hip replacement. This major surgery requires months of physical rehabilitation, and there is no guarantee that the implant will last forever, especially in younger patients.
"There is potentially a limited shelf life for some of these implants because they are typically made of metal or ceramic on plastic joints," Vasileff said. "Problems with implants could mean more surgery for these patients, and it's always more difficult than doing it for the first time."
Subchondroplasty is also much less invasive than total hip arthroplasty, allowing patients to recover more quickly. Vasileff uses it in conjunction with other treatments to help patients preserve their native hip joint as long as possible.
"There are not many procedures that help to regenerate the bone just like subchondroplasty, so it helps fill a void in our treatment options for patients who have cartilage damage, labral tears or advanced degenerative changes in their hips, "said Vasileff.
The Ohio State Wexner Medical Center experts say Subchondroplasty is also helpful for pregnant women who often suffer from temporary osteoporosis during their third trimester of pregnancy or after childbirth. Without this, they are often forced to use crutches for months.