Preserving your natural hip begins with understanding what is causing your pain-not simply treating the symptoms. For young athletes with hip impingement and active adults struggling with persistent stiffness, catching or pain, a thorough evaluation may reveal treatment options that protect joint function while addressing the underlying problem.
Dr. Prem N. Ramkumar provides advanced hip preservation and reconstructive care for patients in Long Beach and throughout Southern California. His approach considers the full range of appropriate treatments, from rehabilitation and activity modification to minimally invasive surgery and reconstruction when necessary.
What Is Hip Preservation?
Hip preservation focuses on treating painful injuries, structural abnormalities and certain early joint problems while maintaining the patient’s natural hip. The appropriate treatment depends on the diagnosis, cartilage condition, alignment, symptoms and activity goals. Preservation is not synonymous with surgery; many patients benefit from targeted nonsurgical care.
Hip Conditions That May Benefit From Specialized Evaluation
- Femoroacetabular impingement (FAI): Abnormal contact between the ball and socket of the hip may contribute to groin pain, restricted motion and damage to the labrum or cartilage.
- Hip labral tears: Damage to the ring of tissue around the socket can cause pain, catching or a sense of instability. Treatment should consider why the tear developed.
- Hip instability, dysplasia and rotational abnormalities: Differences in socket coverage or bone alignment can change treatment planning; arthroscopy alone is not appropriate for every structural problem.
- Tendon injuries and other sources of hip pain: Gluteal and proximal hamstring injuries, among other conditions, can require a different approach from treatment inside the hip joint.
Hip Preservation Treatment Options
A treatment plan may include one or more of the following, depending on the findings:
- Nonsurgical care: Physical therapy, activity modification, strength and movement retraining, medication and selected injections when appropriate.
- Hip arthroscopy: A minimally invasive approach that may treat selected causes of pain within the joint, including FAI and labral injury.
- FAI correction: Femoroplasty or acetabuloplasty may reshape the areas of bone contributing to impingement in appropriately selected patients.
- Labral repair: When suitable, repairing the labrum helps preserve tissue important to hip stability and function.
- Selected corrective or tendon procedures: Some patients require evaluation for rotational correction or repair of injured tendons rather than-or in addition to-arthroscopy.
For patients with advanced arthritis or more extensive joint deterioration, hip replacement or other reconstructive options may provide more dependable relief than preservation surgery. The goal is to recommend the right procedure-or no procedure-for the individual patient.
FAI and Hip Labral Tears: When a Second Opinion May Help
A second opinion can be valuable when hip pain persists despite rehabilitation, imaging shows both impingement and a labral tear, surgery has been recommended, or symptoms continue after a previous procedure. A preservation-focused evaluation looks beyond the MRI finding to assess bone shape, joint stability, cartilage damage and whether the diagnosis truly explains the symptoms.
Patients may want to ask: Is impingement contributing to the labral injury? Is there instability or another structural problem? What can nonsurgical treatment realistically accomplish? If surgery is appropriate, which structures need to be addressed-and why?
Why Choose Dr. Ramkumar for Hip Preservation?
Dr. Ramkumar completed orthopedic sports medicine fellowship training at Hospital for Special Surgery (HSS) and adult reconstruction fellowship training at Harvard/Brigham and Women’s Hospital. HSS is internationally recognized for orthopedic care, including sports medicine, arthroscopy and hip preservation. His complementary training supports evaluation across the spectrum of joint-preserving treatment and reconstruction.
His clinical focus includes hip arthroscopy, FAI, labral repair and reconstructive hip procedures, and his published research addresses hip impingement and arthroscopic treatment. This combination can be especially useful when deciding whether continued conservative care, a preservation procedure or reconstruction is most appropriate.
Frequently Asked Questions
Does an FAI diagnosis automatically mean I need surgery?
No. Some people have FAI-shaped bones without symptoms, and many symptomatic patients begin with nonsurgical treatment. Surgery may be considered when the diagnosis fits the symptoms and appropriate conservative care has not provided adequate relief.
Can hip preservation prevent a future hip replacement?
Preservation aims to address specific problems while retaining the natural joint, but it cannot guarantee that arthritis or a future hip replacement will be prevented.
Explore Your Hip Preservation Options
If hip pain is affecting sports, work or everyday activities-or you want another opinion about FAI or labral surgery-Dr. Ramkumar can review your diagnosis, imaging and treatment history to discuss appropriate next steps.
Related information: FAI and Labral Tears • Hip Treatments • Choosing a Preservation Specialist
