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On-Topic Video Transcript: Management of Nonarthritic Hip Disorders

Craig Mauro, MD

Some of the most common hip disorders we see in patients involve either the soft tissues around the hip, such as bursitis or tendonitis around the hip, particularly involving the hip flexors or involving the hamstrings or the IT band on the side of the hip. Other hip problems come from the hip joint, such as labral tears, early arthritis, or cartilage problems in the hip joint, or even such things as loose bodies deep within the hip joint.

Evaluation Process

There are many non-hip joint problems that can cause pain around the hip joint, such as lumbar spine problems, pelvic pain from gynecologic disorders, hernias and other problems around the pelvis can cause hip joint pain. So really our first step is to take a good history and much of the diagnosis can be established with a good history and listening to the patient. Oftentimes the patient will tell us what the problem is if we sit and listen to them and ask the right questions.

Treatment Options

Once we’ve established the diagnosis of hip joint pain there are many treatment options, and we take a very comprehensive approach, most of the time employing nonsurgical means first. This often involves physical therapists, sometimes an injection, activity modification, and different medications. As surgeons, it’s important for us to identify which patients can best be treated nonoperatively as well as those that would potentially benefit from surgical treatment.

Surgical Techniques

Surgical options for hip disorders primarily involve both arthroscopic and open techniques. Arthroscopic surgery of the hip provides a minimally invasive access to the hip joint for treatment of such things as labral tears, femoral acetabular impingement, cartilage damage, and loose bodies of the hip joint. Open hip surgery is really reserved for repairing tendons around the hip joint as well as for osteotomy which is cutting and reshaping the bones of the hip joint for such things as dysplasia.

Experience and Expertise

At UPMC we have a long history of treatment of hip disorders and in fact some of the pioneers in hip arthroscopy over the last five to 10 years have been at UPMC. We take a comprehensive team approach involving experts in the fields of radiology, anesthesiology, and physical therapy as well as rehab medicine in our approach to hip disorders. We also have pioneering research going on and are teachers both of residents and other surgeons around the country of the techniques we perform here at UPMC.

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