More options for hip problems

Caroline Stephenson was desperate to put an end to the hip pain she had experienced for nearly 11 years. It was affecting her work and her life.

An avid hiker, Stephenson, 47, began to limit her time on the trails. She gave up running when it became too difficult. She even quit a job she loved to avoid the pain of long hours on her feet. After undergoing years of X-rays, scans and MRIs with no answers, she was feeling hopeless.

“I told my doctor that I wanted to see an orthopedic specialist and, if they couldn’t find anything physically wrong, then I wanted to see a psychiatrist,” Stephenson says with a laugh.

In November 2009, she was referred to Dr. Kelly Johnston, a Calgary orthopedic surgeon who specializes in middle-aged adults with hip problems, some difficult to diagnose. Within weeks, Stephenson underwent surgery to repair damaged cartilage caused by her underlying hip dysplasia, a subtle deformation or misalignment of the hip joint.

“The minute I got out of surgery, I could immediately feel the joint was better,” she says.

New approaches to surgery and a better understanding of hip diseases have allowed surgeons like Johnston to offer patients more surgical options, shorter recovery times and fewer long-term problems for symptoms such as hip pain, joint “clicking” and instability.

Johnston says hip replacement surgery is not always the best option for active individuals, especially those under 40 because they would likely need more hip replacement surgeries during their lives. He aims to treat patients while it is still possible to preserve their hip joints and get them back to their normal routines.

In Stephenson’s case, Johnston carefully removed torn cartilage arthroscopically, which involved accessing the hip joint through three small incisions. (An arthoscope is a fibreoptic scope about the size of a drinking straw with precision surgical tools). This type of surgery is less invasive and is easier to recover from than an “open” operation.

Not even four weeks after surgery, Stephenson was already doing a lot of walking.

“It feels really good,” she says. “The intense pain I had for so many years is gone. I intend to still climb mountains.”

Carolyn Fewer, 35, also suffered for years with excruciating hip pain. An elite athlete at an early age, Fewer’s symptoms first surfaced in 1993. Johnston diagnosed her with hip impingement, which results in the femur prematurely contacting the rim of the hip socket.

Johnston is one of only a handful of surgeons in the country who perform minimally invasive, joint-preserving surgery on impingement patients.

Orthopedic surgeons speculate impingement deformity can lead to hip arthritis in young adults.

 “By diagnosing these subtle abnormalities around the hip and then treating them through surgical interventions, the outcome for the patient is an immediate difference in pain and mobility,” Johnston says.

Less than two weeks after having the surgery in February, Fewer was feeling the difference.

“Each day is getting better. The pain is lessening and mobility is increasing,” she says.