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A Destination Center for Hip Pain

The onset of hip pain can occur gradually over time or it can come on suddenly due to an injury. Younger patients often suffer an acute injury and feel a sudden and sharp pain in the groin area.  However, sometimes patients have no idea how the injury occurred but have pain when the hip is flexed forward and internally rotated (when the toes and knees are rotated inward). Older patients often notice pain with activities such as yoga or even simply sitting.

In recent years physicians have become more experienced at diagnosing conditions earlier. Conditions such as hip dysplasia, Femoro-Acetabular Impingement (FAI) and labral tears are commonly seen in young active patients. These things, if not corrected may cause hip pain and can lead to premature arthritis. These conditions are thankfully correctable, and, if caught before significant arthritis develops, can prevent the formation of arthritis in the joint.

Both labral tears and hip dysplasia tend to be more common in females, however these conditions can affect men too.  Certain sports can also place people at a higher risk for a labral tear – from soccer, hockey, ballet, lacrosse, basketball, softball, gymnastics, martial arts, and figure skating. Individuals with a labral tear usually have pain in the front of the hip or groin, and often times they are diagnosed with a muscle pull or a groin strain that doesn’t get better with rest and anti-inflammatory medication. Some young or middle-aged athletes may be predisposed to labral tears, based on the repetitive motion of their activity or sport, including: runners, tri-athletes, volleyball, soccer and hockey players as well as gymnasts and dancers.

Common Symptoms of a Labral Tear

  • Pain in the front of the hip or groin that gets worse with activity or motion
  • Decreased range of motion in one hip, when compared with the other
  • Pain often gets worse with sitting for long periods of time
  • A locking or catching sensation in the hip
  • Difficulty putting on socks or shoes
  • Pain that does not get better with physical therapy

Hip Dysplasia is a condition that is often diagnosed during exams at birth or in infancy. When caught early it can most often be treated non-operatively. However, if diagnosed after the age of two, often surgery is necessary to correct the problem and properly align the bones of the hip joint.

Today, 9 out of every 10 cases of hip dysplasia are diagnosed during adolescence or early adulthood. Hip dysplasia occurs when the hip socket does not form in the normal shape and orientation.  The hip socket, in patients with dysplasia, is tilted, shallow, and not properly aligned or covering the ball of the femur. When this is the case, the ball either rides on the edge of the cup, damaging the labrum, or (in severe cases) is also able to ‘slip out’ of the joint causing pain and cartilage wear.  Not all individuals with a labral tear have dysplasia, but most often someone with dysplasia will also have a labral tear because the wear and tear it causes within the joint.

Common Symptoms of Hip Dysplasia

  • Hip pain caused by dysplasia is frequently associated with activities.
  • Often people describe the pain as coming from deep inside the groin, but it can also radiate from the side or the back,
  • Over time, the pain generally becomes more frequent or the intensity more severe.
  • In some cases, people with this condition may develop a mild limp if they do not address the cause.
  • In severe cases, one can also develop a leg length difference.

It is important to get to the bottom of hip pain because hip dysplasia and labral tears are the leading causes of arthritis in women less than 50 years old.  This often leads to pain and an early hip replacement.

 

The Panorama Difference - Highly Specialized Care for Hip Pain

Top-Trained Team

The team at Panorama Orthopedics & Spine Center Hip Preservation Institute has trained at the top institutions in the United States and have dedicated their careers to the diagnosis and treatment of hip pain in young individuals and athletes. They see patients from around the United States and across the county. They have completed research, authored papers and are sought-after speakers on the topic of labral tears and hip dysplasia.

Diagnosing and treating hip pain is best left to those doctors who specialize in hip arthroscopy.  Labral repair or reconstruction is a technically demanding and specialized procedure within orthopedic medicine and you want a surgeon who does hundreds or thousands of hip arthroscopy procedures to ensure that they possess the skills and experience necessary to achieve a superior result. Dr. Ellman and Dr. Haber are those experts and they perform hundreds of these difficult surgeries every year. Dr. Hugate specializes in complex reconstruction of the bones of the pelvis and hip joint and is a specialist in correcting hip dydsplasia in young adults.   Together, they are a highly specialized team of experts when it comes to diagnosing and treating hip pain in young active patients.

Dr Ron Hugate

Dr. Ron Hugate
Trained: Mayo Clinic – Rochester, MN

Dr. Hugate specializes in the complex reconstruction of the bones of the pelvis and hip joint. Very few orthopedic surgeons in the United States have this expertise. His special training at the Mayo Clinic in minimal incision hip preservation techniques allows him to perform even the most complicated and complex osteotomies to correct hip dysplasia. Dr. Hugate has been featured on numerous TV segments including the Today Show for his innovative expertise.

 

Dr. Mike Ellman

Dr. Mike Ellman
Trained: Steadman Phillipon Clinic – Vail, CO

Dr. Ellman is an orthopedic surgeon trained in Sports Medicine and he specializes specifically in hip arthroscopy.  He completed his fellowship at the Steadman Clinic in Vail and today he performs hundreds of hip arthroscopies a year. A specialist in labral repair and reconstruction, he has authored research, teaches courses to surgeons and has been a featured speaker at national and international medical conferences for his expertise in this area.

 

Dr. Dan Haber

Dr. Dan Haber
Trained: Steadman Phillipon Clinic – Vail, CO

Dr. Haber trained at Dartmouth, Harvard and also completed a fellowship at the Steadman Clinic in Vail, where he specialized in advanced arthroscopic and reconstructive techniques. He has received awards for his research, has published several peer-reviewed journal articles, pioneered new surgical techniques, authored chapters in textbooks, and produced instructional videos. His work has been presented at numerous local, regional, national, and international meetings.

One Surgery Instead of Two

For individuals with hip dysplasia they are most often faced with having two surgeries to correct their condition.  That is because hip dysplasia causes a torn labrum and it is the pain of that injury that usually drives the patient to seek help in the first place.   Hip dysplasia when it persists into young adulthood,  is more difficult to repair and requires a surgical procedure called a ganz osteotomy to do so. Very few surgeons are trained and qualified to complete this procedure that ultimately corrects the positioning of the hip ball and socket.

Once the Ganz osteotomy to repair hip dysplasia is complete, the patient is faced with having a second surgery to repair or reconstruct the torn labrum.  Because of the specialized nature of the surgeries, it requires the expertise of two different types of orthopedic experts and there are very few locations in the country who have these experts working together, side-by-side as a part of the same medical team.

In fact, the Panorama Hip Preservation Institute is one of the only locations in the country that has assembled a team that is able to complete both of these procedures in ONE surgery.

The team approach available at the Panorama Hip Preservation Institute of specialists means that our surgeons work together and with the hospitals in a highly coordinated manner to provide our patients the opportunity to have just one surgery.  This benefits the patient because they only need to go under anesthesia one time and they experience only one recovery.

One surgery instead of two reduces risk, lowers cost, lessens the time spent in hospital and shortens the recovery and rehabilitation time to help patients get back to life, sports and activities quicker.

 

A Destination Center for Hip Pain

At the Panorama Hip Preservation Institute we see patients who travel from near and far and we are well equipped to care for people who travel to us from across the city or around the country.There are several local hotels that provide services for patients and families having surgery in our hospital. You can choose the level of care with which you are most comfortable, and we can provide you with more details on these options.

You will need physical therapy when you return home and we will provide all of the protocols that have been approved by your surgeon to that you can choose a local physical therapist of your choice. Your surgeon will discuss with you a follow-up plan with you prior to your procedure and will review all of the resources that will be available to you upon your return home.

Panorama Hip Preservation Institute has been recognized as a regional center of excellence for hip arthroscopy,  hip dysplasia and labral repair.

  • We are the only center in the Rocky Mountain region offering the opportunity to have both these conditions treated in one surgery.
  • The process is seamless for the patient and the families  – from start to finish is all of the care is coordinated within one medical office which means no referrals to different doctors. For you this means better communication between your medical team and it enables better coordination of care.
  • Our center treats a high volume of these conditions and our doctors have some of the highest patient satisfaction scores and public online ratings. Check them out!

If you or someone you know has been suffering with non-arthritic hip pain that is the result of an injury, we recommend seeking out evaluation by an orthopedic surgeon who is trained in sports medicine and specializes in hip preservation. If the pain doesn’t resolve or improve after 4 – 6 weeks they should see a hip specialist to be evaluated.

 

 

Team

Dr. Ellman

Dr. Haber

Dr. Hugate

Justin Burtz, Physician Assistant

Brooke Mansfield, Physician Assistant

Barbara Wright, Physician Assistant