Hip Preservation: A New Approach to Hip Pain

If you are experiencing persistent or chronic hip pain, the emerging field of hip preservation may be able to provide answers – and get you back to your activities.  Dr. Michael Merz treats patients at the Durham and Chapel Hill locations of EmergeOrtho, and he is fellowship-trained in hip preservation.

The field of hip preservation is a new aspect of orthopedics with three goals:

• To reduce hip pain

• To increase activity

• To prevent degenerative changes

Some hip conditions are misdiagnosed for an average of four or more years; with a correct diagnosis, there are minimally invasive treatment options that not only alleviate the symptoms but also reduce the risk of arthritis in the future.  Hip preservation is a new approach to hip pain treatment.

 

Alleviate Pain by Adjusting the Mechanics of Your Hip

Your hip is a ball-and-socket joint, and many hip problems are mechanical in nature.  This means that adjusting the mechanics of your hip can alleviate pain.  In a pain-free hip, the “ball” fits firmly into the “socket.” Hip dysplasia occurs with the development of shallow hip sockets.  Hip impingement occurs when the ball and socket bump against each other, a condition that can lead to labral tears.  Over time, mechanical issues can damage the cartilage inside the joint, leading to osteoarthritis of the hip.

So what exactly is a mechanical fix?  hip preservation surgery involves reorienting the bones of the hip to improve its function.  Orthopedic surgeons work with patients to determine the best approach if surgery is appropriate; Hip preservation procedures may be performed with traditional cuts or in a minimally invasive way.

As to the age of patients having hip preservation surgery, it varies.  Children and teens may undergo a procedure to correct a developmental problem in their hip joint, but adults in their forties or fifties experiencing hip pain are also excellent candidates.

The Innovation of this Subspecialty Attracted Dr. Merz to Hip Preservation

Dr. Merz pursued a fellowship in this new field at Boston Children’s Hospital, affiliated with Harvard Medical School.  He shares that the innovation of the subspecialty drew him to hip preservation: “It’s really this kind of new field, and I was very excited by the possibilities of helping bring this forward and expand on this field.”  He had comprehensive training with leaders in the field in hip conditions for patients from birth through middle age that included both arthroscopy and osteotomies of the pelvis and femur.

Dr. Merz is trained in general orthopedics, and can see patients for all orthopedic issues.  His dual fellowship training is in hip preservation and joint replacement.  Specific conditions that he treats include:

  • Hip dysplasia (DDH)
  • Femoroacetabular impingement (FAI) or hip impingement
  • Hip labral tears
  • Perthes disease
  • Avascular necrosis (AVN) of the hip
  • Femoral anteversion
  • Congenital hip dislocation