Adolescent and Young Adult Hip Preservation

Hip preservation surgery has become popular in the last decade. It is one of the earliest forms of orthopaedic surgery. It has been used for many decades by paediatric orthopaedic surgeons to treat hip conditions in children and its seqaule. The phrase simply implies that the treatment aims at preserving the biological hip without any major prosthesis.

Dr Balakumar hip preservation program offers evaluation, imaging and treatment for hip conditions that affect older teens and adults in there 20s and 30s and sometimes 40s. These cases are best treated by experts who have background and expertise in the paediatric hip conditions that may have caused the problem.

Conditions treated with Hip Preservation

• Hip Dysplasia
• Femoro-Acetabular Impingement – FAI (CAM/Pincer)
• Slipped Upper Femoral Epiphysis
• Perthes – new and residual (old)
• Avascular Necrosis
• Labral Tears
• Transverse plane mal-alignment in the femur (Miserable mal-alignment)
• Conseuqeunce of Paediatiric Hip Disease

The above conditions need to be pre-arthritc. This means that the cartilage in the joint has to be still intact to be able to preserve the joint.  If the mechanical environment has been severe for long enough, the cartilage is usually damaged beyond preservation. In these cases hip preservation is not an option.

What are the Hip Preservation Options?

Non-Surgical

• Activity modification
• Platlets
• Stem Cells

Surgical

Re-alignment surgery is the main type of hip preservation surgery. This is process of straightening out bones and re-aligning the mal positioned hip or socket (classically referred to as a pelvic osteotomy).

Most of the hip preservation surgery involves cutting bone and redirecting it. This is referred to as an osteotomy. Alternatively one may remove excess bone. This is referred to as an osteotomy. When the damage is to the cartilage or labrum, we repair the cartilage and this is also a hip preservation surgery.

The surgeries that are considered hip preservation are:

1. PAO – Peri-acetabulr Osteotomy
2. Femoral Osteotomy and Fixation
3. Hip arthroscopies and ostectomy of the femur or acetabulum
4. Labral Repair
5. Capital Re-alignment of the Hip
6. Forage and drilling of the Hip for AVN
7. Trap door and bone grafting
8. Surgical hip dislocation

Why Choose Dr Balakumar for Hip Preservation

Dr Balakumar and his team have been trained by some of the forefathers of hip preservation. He is also in a unique situation to be able to offer all types of non-surgical and surgical treatments for hip ailments from birth to advanced age. As he also has an appointment at the Royal Childrens Hospital in Melbourne, Dr Balakumar has an extensive experience and training in hip preservation in the adolescent and young adult population. His mentors in the US are recognised as the world leaders in this area.

Dr Balakumar provides tertiary level teaching of some these advanced techniques.  He has international fellows and visitors from both overseas and locally who come to learn these techniques of open hip surgery.