The focus of the Penn Medicine Center for Hip Preservation is to identify the underlying cause of hip pain and repair or reconstruct the hip joint. Hip preservation techniques are the preferred option for treating adolescents, young adults, and active adults who are looking for strategies other than traditional hip replacement surgery.
Your physicians and surgeons at the center have undergone advanced training (in both the United States and Europe) related to hip preservation techniques, including all facets of interventional, arthroscopic, and open procedures. The Center provides a customized, patient-centered approach to alleviate pain and improve function across the spectrum of hip care.
Conditions Treated with Hip Preservation
Hip preservation means restoring the structural health and function of the hip joint. An allied goal of joint preservation is to minimize pain associated with daily activities, recreational activities, and advanced athletic pursuits.
Patients evaluated and treated at this center include those with Femoroacetabular impingement (FAI), labral tears of the hip, cartilage injury, and sports-related injuries. Developmental and post-traumatic disorders of hip, Hip dysplasia (DDH, CDH), Hip instability, Sequelae of slipped capital femoral epiphysis (SCFE), and Legg-Calves-Perthes (LCP) disease are other commonly treated conditions. The Center has also treated professional athletes, performers, and other patients who place extreme demands on their hips.
Surgical and Non-Surgical Hip Preservation Procedures
We can preserve the hip of people who have healthy cartilage in the setting of underlying structural causes for their hip pain. The goal is to correct issues related to joint anatomy, including bones and soft tissues, of the hip, to prevent further cartilage damage.
Meeting that goal starts with obtaining a detailed history of the hip pain. A key aspect of the work-up also includes imaging tests, such as specialized X-rays, MRIs, and 3D CT scans. These tests show the anatomy and structure of the hip joint, the quality of the cartilage, and the mechanics during movement.
After a thorough medical history and careful physical examination, your provider will typically suggest a variety of treatment options, depending on the underlying cause of the pain.These options are both surgical and non-surgical, and can include:
- Hip arthroscopy:
A minimally invasive surgery to address damage deep inside the hip joint, such as cartilage injury and areas of femoroacetabular impingement (FAI).
- Surgical hip dislocation:
An open surgery in which the hip joint is dislocated from the socket, without reducing the critical blood supply, to address severe deformities and cartilage damage.
- Periacetabular Osteotomy (PAO; Ganz osteotomy):
An open surgery to reorient the hip socket to improve coverage of the head of the femur by the socket, particularly for dysplastic (shallow) hips.
- Femoral Osteotomy:
An open surgery to change the shape of the femur to improve gait mechanics.
- Core decompression:
A minimally invasive technique to address avascular necrosis (AVN or osteonecrosis) of the hip, knee, and shoulder; the procedure involves decompressing areas of dead bone tissue, and, in the same procedure, placing stem cells harvested from patient's own body into the hip to stimulate the growth of new, healthy bone tissue.
- Free-fibular vascularized bone grafting:
Specialized open technique to address avascular necrosis.
- Abductor tendon (gluteus medius/ minimus) tear repair:
Arthroscopic and open techniques to repair and reconstruct tendon tears about the hip.
- Advanced cartilage repair and restoration:
Specialized arthroscopic and open techniques to treat focal cartilage injuries in the hip.
Penn Hip Preservation Center Team
The Penn Medicine Center for Hip Preservation targets the underlying cause of hip pain and repairs and reconstructs, rather than replaces, the hip joint. Our multidisciplinary team is dedicated to the diagnosis and treatment of hip pain in adolescent, young adult and adult patients.
Director of the Hip Preservation Center
Atul F. Kamath, MD
L. Scott Levin, MD, FACS
Charles L. Nelson, MD
Physical Medicine and Rehabilitation / Sports Medicine
Kate E. Temme, MD
Sports Medicine and Cartilage Repair
John D. Kelly, IV, MD
James L. Carey, MD, MPH
Elena Taratuta, MD
J. Bruce Kneeland, MD
The team also includes specialists from Rheumatology, Neurology, Orthopaedic Trauma, Physical Therapy and the Penn Center for Human Performance.