For decades, orthopedic professionals have recommended major surgical interventions for patients dealing with hip problems. On the other side of the spectrum were physical therapy, acupuncture and medicinal cannabis. Today, we have the long-awaited middle ground: naturally regenerative, orthobiologic therapy. Dr. Otten helps us navigate through the noise and answer the important questions.
The hip is a ball and socket joint prone to injuries which bears the vast majority of our body every step we take.
The hip is lined with articular cartilage, something called the labrum, which adds to the support to the entire structure. Think a rubber pillow between two bones to remove friction and add stability.
One of the more common sources of pain is when the articular cartilage or the labrum start to degenerate, causing friction and stress on the bones.
Joints are also supported by complex soft tissue structures, made up of ligaments, tendons and muscle. For example, there’s a large connective ligament to the hip called the ligamen tumteres which connects the ball and the socket.
Like any major joint that bears weight, the hip wears down over time, and arthritis and injuries can set in.
Where Does the Pain Come From?
All hip pain instances can be categorized into new and chronic injuries.
New injuries most often cause articular cartilage damage to the femoral head—the highest part of the thigh bone—or the labrum.
Chronic injuries are old, repetitive injuries that build up over time. This is when we begin to see hip arthritis. Hip arthritis causes deep-seated pain in the groin region, whether you’re walking, resting, or even sleeping.
As mentioned previously, the hip is also supported by muscles, tendons and ligaments. One of the most common injuries to the supportive soft tissue structures is gluteus medius tendonitis, or a partial tear of the gluteus medius tendon.
This also lies where trochanteric bursa is. Both of them surface as pain on the side of the hip. Patients tell us that this pain is specifically pronounced when sleeping on that particular side.
“These issues are difficult to treat, and are often ineffective with cortisone. In my practice over the last 10 years, PRP (Platelet Rich Plasma) and Stem Cells often has a 90% resolution of pain after 3 months,” Dr. Otten shares.
For both new and old injuries, regenerative methods have been found extremely effective for reducing pain and solving the condition. More often than not, patients want to avoid surgical intervention, as they carry significant risks of infection, blood clots and repeat surgeries:
“In the earlier stages, we used arthroscopical interventions, where a long scope is put into your hip. The downtime for the procedure was 6-8 weeks, whereas with Stem Cells or PRP, 1-3 injections can get you significantly better in just a few weeks.”
Arthroscopic intervention or surgeries can often be avoided when we use regenerative (orthobiologic) therapies the in hip problems, during which Stem Cells or PRP are directly injected into the problem area in the hip.
“With the gluteus medius tendon, for example, we need ultrasound guidance to locate where exactly is the source of the pain or dysfunction,” Dr. Otten adds.
With regards to chronic pain from the hip—that deep-seated groin pain—often caused by arthritis, PRP and Stem Cells can be utilized to effectively treat pain. The earlier you “catch it”, the better your results are.
What if you’ve already had hip replacement?
Since the advent of Stem Cells, patients have been asking for Stem Cell therapy after having a hip replacement surgery—for both regenerative properties and pain mitigation. There’s a good reason why:
“Often times, I’m now seeing hip replacement patients with chronic pain that do not want to undergo the knife again to have a total hip revision. These patients respond very well to Stem Cell therapies.”
“Before we perform any intervention on a total-hip-replacement hip, I always find it important to inject the hip with lidocaine or a numbing medicine; we do this under live X-ray to ensure that that is the source of the pain before proceeding forward with the Stem Cell or PRP treatment,” lead physician adds.
What happens during your initial consultation?
If you’re interested in naturally regenerative orthobiologic treatment, an initial examination will be performed by board-certified physicians.
Here’s what Dr. Otten says about the initial examination:
“When you come in for your consultation, we’d like to review your X-ray and MRI pictures, if possible. The MRI shows us the cartilage and the soft tissue, including the tendons and ligaments. The X-ray shows us the joint space availability, or how well-preserved your joint is.
So when you visit with us, we’ll go through both your MRIs and your X-rays to make sure you’re a good candidate for these procedures.
If you are a good candidate for these procedures, whether it’ll be bone marrow, adipose area, or autologous Stem Cells, we always do this under live X-ray with a combination of ultrasound to make sure we’re in the joint prior to the injection.
Whether you’re suffering from a new hip injury, a chronic condition, or post-surgical pain, we have solutions for you.”