The Total Joint Center is dedicated to the care and treatment of hip pain. Our orthopedic surgeons offer many effective treatment modalities and always utilize the least invasive measures to treat your pain.

Hip replacement:
Hip replacement surgery has improved markedly over the last 20 years due to improvements in design and materials. 99% of the hip replacements performed at the Total Joint Center are performed without cement (non-cemented).

Anterior Approach:
The anterior approach to hip replacement requires that during surgery, the hip is dislocated to the front. This causes weakness in the front of the hip after surgery. Hip precautions for the anterior approach include: no hip extension, no external rotation of the hip, no crossing your legs. You must maintain these precautions for 6 weeks.

Posterior Approach:
With the posterior approach the hip is dislocated to the back during surgery. You are weakest in the back of your hip after surgery; You must not bend the hip to chest or chest to hip greater that 90 degrees, internally rotate the hip or cross your legs for 90 days after surgery.

Cross-linked polyethylene:
Cross-linked polyethylene is a relatively new plastic insert that has a low coefficient of friction. Friction wears away the plastic. This new plastic is anticipated to last 20-30 years.

Metal-on-metal hip replacement:
Due to new advances in technology they are able to machine the metal on metal hip to a fine degree, so, again, there is very little wear and very little friction.

Ceramic hip replacement:
The high performance ceramic hip was recently approved by the FDA. Previously ceramic prostheses had difficulties with cracking and breaking.

The MIS (Mini-incision) hip replacement:
Developed in Warsaw, Indiana by Zimmer, Inc., this minimally invasive surgery (MIS) for hip replacement was first performed in February, 2002. MIS techniques are used with clinically proven implants and can shorten recovery times, reduce length of stay in the hospital and result in much smaller scars (3-4 inches versus the standard incision of 6-12 inches).

The instruments used in MIS have been improved and modified to enable surgeons the ability to properly align and place the implants though a much smaller incision. This smaller incision also helps to minimize blood loss and post-surgery pain. 3 of the surgeons at the TJC utilize the MIS surgery for hip replacement.

Injections
The hip joint can be injected with a cortisone-like material that acts as a powerful anti-inflammatory. It is given most often along with lidocaine. The cortisone-like material causes some mild destruction to the cartilage. Injections can bring relief for years, months or weeks. If it brings only 2 hours of relief, it is diagnostic and means that your hip problem has progressed to an end-stage of degeneration.

Minimally Invasive Hip Arthroscopy
Hip arthroscopy is a minimally invasive procedure similar to knee arthroscopy. A small camera lens, inserted in the hip joint through a quarter-inch incision, displays imaging on a television monitor, while surgical instruments are manipulated via a second small incision. The procedure takes less than one hour. Patients go home on crutches, which are usually discarded within a few days. Dr. Sampson developed the lateral approach to hip arthroscopy, specifically to treat labral tears and femoral-acetabular impingement syndrome, which is often undiagnosed with plain x-rays. Prior to the development of this technique, arthroscopy had seldom been used as a diagnostic and therapeutic tool for hip pain, due to the extensive muscular anatomy of the hip joint.

Femero Acetabular Impingement
Femero-Acetabular Impingement is experienced by the patient as groin pain. It may initially be from a sprain but it doesn't get better. It can cause labral tears and arthritis of the hip. Femero-Acetabular Impingement is usually treated with removal of the impinging bone at the femoral head-neck junction. Dr. Thomas Sampson has developed an outpatient arthroscopic approach to its treatment instead of a surgical dislocation, which requires an inpatient stay.