Specialized consultation and treatment for athletes and active adults to evaluate options from protecting natural joints to reconstruction.
Hip and knee pain can interrupt a season, limit exercise, or make everyday activities difficult. But a painful joint does not automatically mean joint replacement is the next step. Depending on the diagnosis, there may be ways to address the injury, restore stability, correct abnormal mechanics, or treat a specific area of damage while retaining the natural joint.
Dr. Prem N. Ramkumar provides comprehensive hip and knee care for patients throughout Long Beach, Los Angeles, Orange County, and Southern California. His dual fellowship training in orthopedic sports medicine and adult reconstruction gives him experience across joint-preserving procedures and joint replacement so that an evaluation can focus on what is appropriate for the patient, not a single category of surgery.
What Is Hip and Knee Preservation?
Joint preservation refers to nonsurgical and surgical strategies intended to maintain a patient’s natural joint and its function. It is not one operation, and it is not appropriate for every condition. Treatment may involve rehabilitation and activity changes, arthroscopic repair, ligament reconstruction, cartilage restoration, or realignment surgery. For patients with advanced joint damage, replacement may offer more predictable relief.
Hip Preservation: Addressing the Source of Pain
Hip pain in a young athlete may arise from femoroacetabular impingement (FAI), a labral tear, tendon injury, or an abnormality in the shape or rotation of the hip. Identifying the source matters: treating pain alone may leave the underlying mechanical problem unaddressed.
- FAI evaluation and, when indicated, arthroscopic correction of cam or pincer impingement
- Hip arthroscopy and labral repair in appropriately selected patients
- Evaluation of hip alignment, rotational abnormalities, tendon injuries, and other causes of persistent hip pain
Knee Preservation: Repair, Restore, Stabilize
Dr. Prem Ramkumar may consider knee preservation for athletes with ligament or meniscus injuries and for active adults with localized cartilage damage or alignment-related wear and tear. Surgical options depend on whether the problem is a focal injury or more widespread arthritis. Knee preservation treatment may include:
- Meniscus repair and selected cartilage repair or transplantation procedures
- ACL, MPFL, and other ligament reconstruction for instability
- Knee osteotomy to shift forces away from a damaged knee compartment in carefully selected patients
Why Expertise in Joint Preservation and Reconstruction Matters
Sports medicine training often emphasizes arthroscopy, ligament injuries, and athletic function. Adult reconstruction training emphasizes complex joint disease, partial and total replacement, and revision surgery. It is important that you find a specialist who does both.
Dr. Ramkumar completed his orthopedic sports medicine fellowship at Hospital for Special Surgery (HSS), ranked No. 1 nationally for orthopedics for 17 consecutive years by U.S. News & World Report (2026–2027), and No. 1 worldwide for orthopedics by Newsweek in its 2027 rankings. Combined with his adult reconstruction fellowship training at Harvard/Brigham and Women’s Hospital, this background supports his comprehensive approach to hip and knee treatment.
It is important to note that joint preservation isn’t always the best option, and joint replacement may be more appropriate for some patients. The right choice depends on several factors, including the severity of arthritis, the location of joint damage, and the patient’s activity goals. A thorough consultation with Dr. Ramkumar will help determine which treatment offers the best opportunity for pain relief, improved function, and a realistic recovery.
When a Second Opinion Will Help If Considering Joint Preservation?
An additional evaluation may be helpful if you continue to experience symptoms despite rehabilitation. It may also be worthwhile if you’ve been diagnosed with FAI, a labral tear, or a complex cartilage or ligament injury. If joint replacement has been recommended, a second opinion can help you understand whether other treatment options are appropriate. The goal is to provide clarity about your options, not to promise that surgery can be avoided.
Related information: Hip Preservation and FAI • Knee Cartilage Repair • How to Choose a Specialist
