Hip preservation can prevent future complications, arthritis & early hip joint replacement surgery

Hyderabad, April 15^th, 2019:
Not many, especially the young adults and children, are aware that pain in
thigh or knee may sometimes indicate hip problems and any delay in diagnosing
and treating the problem will lead to irreversible damage and arthritis of
the hip joint. If hip preservation surgery is performed in young patients,
it will delay or arrest arthritis and also helps in avoiding or
delaying total hip joint replacement surgery in future. Dr.
Raghuveer Reddy K.,
Sr. Shoulder & Knee Surgeon, SISA, Hyderabad and Dr.
Gourineni Prasad, renowned pediatric & young adult
orthopaedic surgeon from Chicago, briefed media on the
latest and much finetuned techniques to treat the hip problems in children and
young adults.   

To focus on these and other related
issues, SISA Hospital (Sai Institute of Sports Injury and
Arthroscopy) hosted the 12^th SISA 2019 Advanced Hip
Preservation Workshop, on Sunday. The Workshopfamiliarized Orthopaedic
surgeons with the advanced techniques. Over 350 surgeons from different parts of
the country participated in the workshop to learn these techniques
focused on preservation of Hip joint.

The hip joint is a major ball and
socket designed to give the ability to sit, squat, stand, run, and jump without
popping out or wearing down during our life time. However, hip pain is becoming
common even in young people. The pain is usually not severe in early stages and
the diagnosis is not made readily without advanced training to doctors. Most
hip arthritis is secondary to shape alterations of the bones. Several of these
alterations start at a young age while a few conditions start in
adulthood. We now have the knowledge and information to identify these
alterations early, treat them, and prevent arthritis. The goal of this meeting was
to disseminate this knowledge to more Orthopaedic surgeons so that more people
can be helped.

Dr. Raghuveer Reddy K., said, there
are several childhood diseases leading hip damage such as congenital
dislocation where the child is born with a dislocated hip, infection of the
joint (septic arthritis), problem with circulation of the ball (Perthes
disease), ball slipping on the thigh bone (Slipped epiphysis) etc., the
incidence of these is in the range of 1 in a lakh and normally seen when the
child is between 10 to 14 years of age. There are newer problems especially in
young adults like jamming of the hip bones known as femoroacetabular
impingement, commonly seen in 25 to 30 years age group, with incidence being in
the range of 1% of the population in that age group, leading to shape
alterations. Appropriate early treatment can decrease the chance of these
alterations.

Dr. Raghuveer Reddy said, these problems
can be prevented by activity modification and going back to our older habits,
of sitting on the floor and squatting or activities involving stretching of
hip, doing yoga, seem to have a preventive role in the development of
femoroacetabular impingement. These modifications can help especially when the
child is between 5 to 10 years and the hipping is in a formative stage.
Carrying the baby with their hips spread apart is well known to promote healthy
hip development.

Once the alterations occur,
correcting them in the hips that are at risk is now a well-established
approach. With newer knowledge of the blood supply to the hip, we have the
ability to safely deepen, rotate, or reduce the socket size, change the shape
of the socket, make the ball smaller and rounder, lengthen the neck, and
strengthen the muscles. We can also place new cushion on the ball and socket in
selected patients.

The standard surgical procedures
with larger incisions and longer recovery are safer now, but most of them can
be accomplished with smaller incisions and day care surgery. Arthroscopy of the
hip, a technically difficult procedure not so popular in India, but has
tremendous potential to perform the treatment with tiny incisions, less pain,
faster recovery and very good results.

Dr. Gourineni Prasad, born and raised in India,
practicing in Chicago, and committed to spreading hip knowledge in India had
the unique opportunity to learn modern hip preservation from its beginning from
the original Swiss surgeons and accumulated unmatched experience with both open
and arthroscopic techniques for 20 years. He simplified the approach
greatly while maintaining its accuracy and his results are on a par with any
international expert in the field.

Speaking on the occasion Dr.
Gourineni Prasad, said,
hip preservation means saving the hip which is at risk from arthritis or hip
pain, necessitating hip replacement. This need identifying the hips at risk and
treat them with appropriate surgical technique before the damage happens. This
idea started in Bern, Switzeraland, but I was lucky to have learnt it when it
was just getting popularized and then we expanded it in USA. Now I am trying to
popularize these techniques in India by exposing it to many surgeons here. Off
late Hip pain and arthritis is becoming more common than it was even a
generation ago, especially in India. The reason being we became more Westernized,
the earlier generations used to sit on the floor crossing our legs, squatting,
people don’t do it anymore. The squatting which helped the hip to develop
properly is not happening anymore, therefore the hip problem is becoming more
common in India. Our culture of squatting was beneficial in hip development. It
is preventable if children are educated to stretch their legs at a young age,
squat, sit down, do yoga, especially between 5 and 10 years such activity
modification helps. Early recognition of the problem allows to detect and
treat. If the hip pain is not severe in children, they may not seek proper
treatment. If the doctor they go to doesn’t diagnose the problem properly and
treats it with some medicines for pain relief or if the child altogether avoids
activities which cause pain, the problem will continue to exist and they live
with it. But in due course it can lead to arthritis or damage, which is
preventable and avoidable if recognized early. Today we have several new
techniques which existed but have been modified, improved, finetuned to produce
much better outcomes.    

He collaborated with Dr. K. Raghuveer Reddy and dedicated himself to treat children and young adults with hip problems at SISA centre, Hyderabad and his soon to be launched world class center at Tirupati known as Amara Hospital.