Healthcare News

Arthroscopic Treatment of Hip Pain in Adolescent Patients With Borderline Dysplasia of the Hip: Minimum 2-Year Follow-Up
Source: Arthroscopy: The Journal of Arthroscopic and Related Surgery 

This study shows favorable 2-year outcomes in adolescent patients with borderline dysplasia undergoing labral treatment and capsular plication. Outcomes in the borderline dysplastic patients were as good as those of a control group. Although adolescents with borderline dysplasia have traditionally been a challenging group of patients to treat, these results suggest that an arthroscopic approach that addresses both labral pathology and instability may be beneficial.

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Outcomes of Hip Arthroscopy in Competitive Athletes
Source: Arthroscopy: The Journal of Arthroscopic and Related Surgery 

Patient-reported outcomes and VAS in athletes significantly improved at a minimum of 2 years after capsular plication as a part of hip arthroscopy addressing varying pathologies. In addition, most patients returned to sports at similar or higher competitive levels. These results suggest that capsular plication is a favorable treatment option in athletes with ligamentous laxity and/or borderline dysplasia.

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Even low level of physical activity may cut fracture risk
Source: Medical Xpress

Short daily bouts of walking/bicycling and a few weekly exercise sessions are both associated with a lower rate of hip fracture and any fracture, according to a study published online April 29 in the Journal of Bone and Mineral Research.

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AAOS releases new clinical practice guideline for osteoarthritis of the hip
Source: Medical Xpress

The American Academy of Orthopaedic Surgeons (AAOS) recently released a new clinical practice guideline (CPG) on the treatment of osteoarthritis of the hip that strongly recommends the use of pre-surgical treatments to ease pain and improve mobility, including corticosteroid injections, physical therapy and non-narcotic medications.

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Dry needling offers alternative to cortisone injection for hip pain
Source: Medical Xpress

Dry needling may be a viable treatment alternative to cortisone injection for patients with chronic, intermittent pain and tenderness on the outside of the hip, thus avoiding the potentially harmful effects of steroids, according to a new study published in the April 2017 issue of the Journal of Orthopaedic & Sports Physical Therapy (JOSPT)..

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Hip Preservation Program
Source: www.tricitymed.org

Dennis Hamblin, 53, enjoys the adrenaline rush of hitting the slopes on his skis and has always lived an active life since he was on his high school’s track team. After track practice, Dennis often joined friends in pickup football games and it was during one of these pickup games that he initially injured his groin. Over the next several years, Dennis dealt with the groin pain from the injury he sustained his sophomore year in high school. With youth on his side, Dennis found that by skipping key stretches he was able to manage the pain and went on to a successful career as a distance running competitor at the collegiate level. However, improperly addressing his true injury took a toll on his body.

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New Pediatric Supracondylar Humerus Fractures CPG
Source:
www.aaos.org

Members of the workgroup included: Andrew Howard, MD, chair; Kishore Mulpuri, MBBS, MS (Ortho), MHSc (Epi), vice-chair; Mark F. Abel, MD; Stuart V. Braun, MD; Matthew J. Bueche, MD; Howard R. Epps, MD; Harish S. Hosalkar, MD; Charles Mehlman, DO, MPH; Susan Scherl, MD; Michael Goldberg, MD, Guidelines Oversight Committee chair; Charles Turkelson, PhD; Janet L. Wies, MPH; and Kevin Boyer.

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Three Scientific Exhibits Cited; POSNA Receives Special Award
Source:
www.aaos.org

The Special Award went to SE42—POSNA: Infantile DDH: Screening, Safe-swaddling, Harness Application and Follow-up Protocol by *Harish Hosalkar, MD; *Scott J. Mubarak, MD; Ernest L. Sink, MD; Kishore Mulpuri, MD; and Chad T. Price, MD.

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A Pat on the back to …
Source:
www.aaos.org

The winners of the J. Robert Gladden Orthopaedic Society DePuy Educational Assistance Awards: Ethan Kellum, MD; Brent Stephens; Wilsa Charles; Comrie Frederick Kyle; Addisu Mesfin, MD; Harish Hosalkar, MD; Randolph Sealey, MD; Erica Taylor, MD; MaCalus V. Hogan, MD; and Saadiq El-Amin, MD, PhD.

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SCFE leads to Symptomatic FAI
Source:
www.aaos.org

“Data have shown that slipped capital femoral epiphysis (SCFE) treated with pinning in situ can develop into symptomatic femoroacetabular impingement(FAI) over time,” said Harish S. Hosalkar, MD.

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Hip Preservation Program
Source:
www.tricitymed.org

Dennis Hamblin, 53, enjoys the adrenaline rush of hitting the slopes on his skis and has always lived an active life since he was on his high school’s track team. After track practice, Dennis often joined friends in pickup football games and it was during one of these pickup games that he initially injured his groin. Over the next several years, Dennis dealt with the groin pain from the injury he sustained his sophomore year in high school. With youth on his side, Dennis found that by skipping key stretches he was able to manage the pain and went on to a successful career as a distance running competitor at the collegiate level. However, improperly addressing his true injury took a toll on his body.

“I had many lower back issues and issues with restricted range of motion. I always assumed this was because I didn’t like stretching and ran about 120 miles per week when I was competing.”

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New Hip Surgery Relieves Hip Pain and Impingement, Extending Usable Life of Patients’ Natural Joint
Source:
www.marketwired.com

Tri-City Medical Center is expanding its services to include hip preservation surgery, a reliable alternative to total hip replacement for active adults and young patients. Doctors at Tri-City Medical Center’s Orthopaedic & Spine Institute are utilizing advanced joint preservation procedures to provide hip pain relief, treat painful hip impingement and help extend the usable life of patients’ natural joints, thus avoiding total joint replacement procedures.

Over the years, youth sports have become more intense and popular. As a result, more young and mid-life adults are arriving in doctors’ offices suffering pain and restricted motion in their hip joints. This is especially true for former or current athletes who have competed in high-impact sports such as basketball, football, lacrosse, baseball and ice hockey. This population is most prone to a condition called Femoroacetabular Impingement, or FAI, which affects the hip joint. Symptomatic FAI is now known to be a pre-arthritic condition.

“Hip preservation surgery with open safe surgical dislocation or arthroscopic means is rather new and many patients aren’t aware of its availability as a modality of treatment,” says Harish S. Hosalkar, MD, hip preservation and deformity correction specialist at Tri-City Medical Center. “For younger patients, a total hip replacement surgery might not last their lifetime, requiring them to replace the same joint more than once. Preservation of the joint means we maintain the natural joint without any resurfacing to alleviate hip joint pain and improve motion and function by restoring the anatomy of the joint.”

Many patients mistake hip pain as an alignment issue or arthritis, but it can often be undiagnosed adolescent or adult hip dysplasia, which can only be corrected through reconstructive surgery. The pain from FAI is caused by abnormal abutment motion between the ball of the hip joint and the socket, often leading to a tear in the surrounding cartilage (labral tear). With hip dysplasia, a shallow hip socket causes problems related to under-coverage. Men and women are both prone to hip dysplasia and FAI, either through their inherent anatomy, genetics or through heavy sports activities and injuries.


Cure of a rare hip infection
Source:
bangalore.citizenmatters.in

A 3-year-old girl from rural India with a complex hip infection is now able to walk after a successful surgery by doctors at Columbia Asia Referral Hospital – Yeshwanthpur in Bangalore. A group of doctors at the hospital, led by Dr. Harish Hosalkar from San Diego, California and Dr Kamini Kurpad, a pediatric orthopedic surgeon from Columbia Asia, completed the surgery.

The girl had an infection from infancy that had deformed her hip joint, making it impossible for her to lead a normal life. Because of the condition, sequelae of septic arthritis, she had a limited movement in her hip and could walk only with a limp.

During the surgery, the doctors deepened the the socket of her hip joint and redirected the head of the thigh bone into the deepened socket. They also fixed the neck of her femur to help in the remodeling of the joint. The surgery helped keep her hip stable, improve the range of motion and decrease her limp.

After five days, the girl was discharged while in a cast and advised to undergo physiotherapy to aid the recovery of her hip movement within six weeks. Her family could not afford medical care, and the doctors performed the surgery for free.


Getting along Swimmingly
Source:
www.utsandiego.com

Amanda Geier doesn’t smile when she recounts the medical advice she once received about her daughter Samantha’s spina bifida. “I was told that what’s going to happen is going to happen, and there’s no point in trying to prevent anything,” she said.

For the Geier family, that simply wasn’t good enough. “You learn to fight for your kid to be able to do the things she wants to do,” Amanda said.

Spina bifida is a congenital condition in which the spinal cord, or the vertebrae which surround it, do not completely form, damaging nerves and causing muscle weakness. Samantha had her first surgery at Rady Children’s Hospital-San Diego when she was 6 weeks old. The procedure allowed her spinal cord to move normally, rather than being tethered at its base. Now 16, Samantha has had several procedures since.

The condition presents many obstacles, and Samantha has learned to overcome them one by one. It hasn’t been easy. Early on, Samantha was relatively untroubled by the disease. But as she grew, scar tissue on her spinal cord forced a second surgery, after which she lost muscle function. She had to give up some activities, such as dance and soccer.

Undeterred, Samantha started swimming, an ideal exercise because it’s not weight-bearing. She went on to compete, excelling at the longer distance freestyle and backstroke events and participating in the Paralympics. But spina bifida interfered once again, as her hip began popping out of its socket, causing intense pain. Her hip muscles were just too weak to hold the joint in place. When swimming, Samantha’s flip turns would sometimes pop the hip, but otherwise the condition was unpredictable.

“I didn’t know when it would happen,” said Samantha. “It could happen in bed.”

The only answer was more surgery. Harish Hosalkar, M.D., a pediatric orthopedic surgeon who also directs the Hip Research Center at Rady Children’s, stepped in to fix the problem, performing a challenging muscle transfer procedure.

For the Geiers, Dr. Hosalkar was the ideal surgeon, approaching Samantha’s treatment with the same mixture of optimism and straight talk the family has come to appreciate. “He’s realistic,” Amanda said. “He tells you what can and cannot happen. He explains there’s no guarantee.”

“We all understood it was a difficult procedure,” Dr. Hosalkar said. “But I told them, if nothing else, I could stop the pain.”

The surgery was done in summer 2011. Since then, Samantha’s hip hasn’t popped out once, and she’s no longer in pain. She’s back in the pool and hopes to compete again in the future.

“The surgery has given back her ability to swim,” said Amanda. “It’s one of the few aerobic exercises that is readily available and that she can do to stay healthy for a lifetime. It’s wonderful that she has that option.”

Having overcome this most recent obstacle, Samantha has other tasks to occupy her. She is an excellent student, sings in the choir and tutors others. For her, spina bifida is now mostly an inconvenience.

“I need to plan ahead and allow more time to get things done,” Samantha said. “I have to factor in time to put on my leg braces and check out wheelchair access. I try to figure out the fastest, most productive way to get where I want to be.”

One of the places she wants to be is college. Though moving away from home will present a new set of challenges, Samantha is looking forward to the adventure. Spina bifida will just have to get out of the way.

Sixteen-year-old Samantha is an accomplished Paralympics swimmer.


He’s the comeback kid of Junior Worlds
Source:
www.utsandiego.com

“It’s something I would hope no parent has to go through,” Don said. “The hardest thing in my life was watching that helicopter take off. It was really scary.”

The Ochoas, who recently moved to Carmel Valley from Rancho Santa Fe, previously mingled golf and motocross with ease. Danny, who turned 15 in May, started riding motorcycles at the same age — 9 — he first competed in SDJGA events. His latest motorcycle was a prize for nearly winning the U.S. Kids Championship last summer in Pinehurst, N.C.

“The whole reason we were out (at the track) was for a reward,” Don said. “And I thought I’d ruined his golf career.”

Dr. Harish Hosalkar, an orthopedic surgeon at Children’s, spent hours putting Danny’s arm back together. He inserted two nine-inch titanium rods into the bone to provide stability. They won’t come out until the end of this summer.

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Researchers found better cup, stem survival after early THA
Source:
Healio

Patients who underwent early total hip arthroplasty experienced better 10-year cup and stem survival compared with patients who underwent late total hip arthroplasty, according to study results.

Researchers searched the Medline databases from January 1990 to January 2014 and retrieved 19 articles reporting on the management of posttraumatic arthritis of the hip following acetabular fractures with the use of late total hip arthroplasty (THA), as well as articles where acetabular fractures were treated with early THA. In all, the researchers assessed THA outcomes following acetabular fracture in 654 patients.

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Most dislocated hips placed within ‘safe zone’ during THA, study finds
Source:
Healio

DALLAS — During their minimum 2-year follow-up, researchers here reported a 1.9% rate of subsequent dislocation after total hip arthroplasty in a contemporary practice and noted 58% of these cases had an acetabular socket position within the Lewinnek safe zone.

“Most contemporary total hip arthroplasties that dislocate are within the Lewinnek safe zone,” Matthew P. Abdel, MD, said during his presentation at the American Association of Hip and Knee Surgeons Annual Meeting. “Cup position for some patients certainly lies outside this safe zone. Most importantly, new technologies will need better targets to hit prior to them being clinically relevant or economically feasible.”

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Preterm, low birth-weight babies may need new hips in adulthood
Source:
Science Daily

Researchers from Australia report that low birth weight and preterm birth are linked to increased risk for osteoarthritis (OA)-related hip replacements in adulthood. The findings also indicate that low birth weight and pre-term babies were not at greater risk of knee arthroplasty due to OA as adults.

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Therapy car’ helps orthopedic patients avoid falls
Source:
Science Daily

A “therapy car” is being used by physical and occupational therapists to help patients recovering from hip and knee replacement surgery simulate getting in and out of a real vehicle without falling or injuring themselves.

Concurrently, Virginia Mason’s application for a patent on this invention is being reviewed by the United States Patent and Trademark Office.

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THA outcomes, surgeon volume effects can be effectively managed
Source:
Healio

Studies dating back nearly 20 years have shown a correlation between surgeon volume and the rate of complications in total hip arthroplasty, with higher-volume surgeons yielding lower complication rates.

“There are a fair number of studies now that establish pretty clearly that volume matters — independent of the volume done by the hospital,” said Jeffrey N. Katz, MD, MSc, professor of medicine and orthopedic surgery at Harvard Medical School and Brigham & Women’s Hospital in Boston.

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Obese patients had poorer outcomes, early revision after THA
Source:
Healio

Patients who were obese and underwent total hip arthroplasty had lower Oxford Hip Scores at 6 months and an increased early revision rate compared with patients who had a lower body mass index, according to study results.

Searching the New Zealand National Joint Registry, researchers retrieved data for 5,357 patients who had primary total hip arthroplasty (THA) from October 2010 to December 2011. Outcomes included functional status as measured by the Oxford Hip Score at 6 months after surgery and revision for any reason. Associations between body mass index (BMI), American Society of Anesthesiologist (ASA) scores, length of surgery and cementation of components were also examined.

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Unnecessary hip MRIs raised costs for patients with hip osteoarthritis
Source:
Healio

Due to the cost unnecessary hip MRIs places on the patient population, referring physicians should not simultaneously order a radiograph and an MRI for hip pain, according to researchers.

To identify the number of new patients with hip osteoarthritis who had an unnecessary MRI, the additional costs of these MRIs and the extrapolated cost to the United States health care system during the next 10 years, researchers prospectively evaluated every patient referred to their institution during a 36-month period.

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  • Tri-City Medical Center - Harish S. Hosalkar, MD - Adult & Pediatric Orthopedist
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Contacts

Tri-city Medical Center, OceanSide

4077 5th Avenue
San Diego, CA 92103

Phone - Harish S. Hosalkar, MD - Adult & Pediatric OrthopedistPhone: (619) 294-8111

Scripps Mercy Hospital, San Diego

4077 5th Avenue
San Diego, CA 92103

Phone - Harish S. Hosalkar, MD - Adult & Pediatric OrthopedistPhone: (619) 294-8111

Scripps Mercy Hospital, Chula Vista

435 H Street
Chula Vista, CA 91910

Phone - Harish S. Hosalkar, MD - Adult & Pediatric OrthopedistPhone: (619) 691-7000

Scripps Hospital, Encinitas

354 Santa Fe Drive
Encinitas, CA 92024

Phone - Harish S. Hosalkar, MD - Adult & Pediatric OrthopedistPhone: (760) 633-6501

Sharp Grossmont Hospital, La Mesa

5555 Grossmont Center Drive
La Mesa, CA 91942

Phone - Harish S. Hosalkar, MD - Adult & Pediatric OrthopedistPhone: (619) 740-6000

Paradise Valley Hospital, National City

2400 East Fourth Street
National City, CA 91950

Phone - Harish S. Hosalkar, MD - Adult & Pediatric OrthopedistPhone: (619) 470-4321

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