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Total Hip Arthroplasty

In a total hip arthroplasty, the cartilage that lines the hip joint is a source of pain and is thus removed. The damaged ball of the hip joint is replaced with a metal ball that is attached to a metal stem, which is fitted in the femur. The socket of the hip (acetabulum) is replaced with a metal cup that has a plastic liner.

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Proximal Hamstring Repair

During an open proximal hamstring repair, an approximately 3–5 cm incision is made at the crease of the buttock. Next the damaged hamstring tendon is located and any frayed or damaged tissue is removed. Once a clean edge of healthy tendon is achieved, it is secured using strong suture back to its insertion on the ischial tuberosity of the pelvis.

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Arthroscopic Trochanteric Bursectomy

Through a small incision on the side of the thigh, a tiny shaver instrument is used to clean out the bursa. All of the inflamed, damaged, or frayed tissue is removed. This may be combined with an iliotibial band release, labral repair, and/or osteoplasty of femoral neck and acetabulum.

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Arthroscopic Partial Iliopsoas Tendon Release

The partial iliopsoas tendon release can be performed arthroscopically. Instead of releasing the tendon completely, which may lead to postoperative weakness, a partial tendon release is preferred. Using a heat device, the tendon is partially released and by doing this, the tendon is lengthened. This lengthening allows the tendon to glide over the hip joint and not snap any further.

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Arthroscopic Labral Repair with Osteoplasty of Femoral Neck and Acetabulum

The labrum is repaired using strong suture that is wrapped around the sagging or torn part of the labrum. By using surgical anchors, essentially small plastic pegs that hold the suture in place, the labrum can be resecured to its appropriate position on the rim of the acetabulum. These pegs do not contain metal and will break down and dissolve away over time. The suture will keep the labrum fixed to the rim of the acetabulum, and will help the labrum scar into position. It is common to use two or three of these anchors in a hip arthroscopy with labral repair.

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Arthroscopic Labral Reconstruction

A patient undergoing this procedure will have their labrum reconstructed with use of an allograft (cadaver tissue) or the patient’s own tissue (commonly iliotibial band is used). The reconstruction of a damaged or incomplete labrum is important to recreate the suction seal function of the labrum in the hip joint. This provides the patient with hip stability and resolves pain commonly associated with a labral tear.

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Arthroscopic Iliotibial Band Release

Through a small arthroscopic incision, the IT band can be located on the outside of the thigh. In the procedure, a portion of the IT band is excised so that an opening is created over the greater trochanter. By removing this piece of the IT band, it will no longer get caught on the greater trochanter and thus the snapping sensation will no longer occur.

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Trochanteric Bursitis

Trochanteric bursitis is inflammation of a fluid-filled sac on the side on the hip. This is often a result of a tight IT band. Patients will experience soreness and pain on the side of the hip, as well as difficulty with sleeping on their side. Treatment involves medications, physical therapy, injections, and sometimes requires surgery.

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Snapping Hip – Internal

Internal snapping hip is a condition where a patient has a snapping sensation when the leg is brought from a flexed position to a straight leg position. The snapping can sometimes be painful and cause discomfort when a person is exercising. Treatment for internal snapping hip may include medications, physical therapy, and possibly arthroscopic surgery.

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IT band snapping across greater trochanter of the hip

Snapping Hip – External

An external snapping hip is when the patient experiences a snapping sensation on the outside of the hip that is painful. This is often a result of a tight iliotibial band (IT band). Treatment for external snapping hip syndrome may include medications, physical therapy, and sometimes surgical intervention.

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