At Arthritis & Sports, we are at the forefront of new technology and advances to help us provide the best quality care to our patients. In the last 12 months, there have been several advances in hip arthroscopy, which Dr. David Goodwin has adopted into clinical use. These advances have helped our patients decrease the risk of nerve injury, reduce surgical time and pain, and provide new options for hip preservation and reconstruction.
Historically, hip arthroscopy is associated with an estimated 13% incidence of nerve injury. While most nerve injuries resolve within 9 months, Dr. Goodwin saw an opportunity to help his patients avoid this risk altogether. By using a tractionless hip arthroscopy table (seen below), patients are placed in a slight trendelenburg (head lower than legs) position to assist with opening the joint for surgical care. "Utilizing this technology allows our patients to wake from surgery with significantly less pain," says Dr. Goodwin. "By eliminating the significant pull on the leg and pressure on the pudendal nerve, patients have reported a 0% incidence of nerve injury since this technology became available less than a year ago."
Pictured: Stryker's Pivot Guardian Distraction System (left) provides better access to the hip joint during surgery, while HipCheck (right) allows surgeons to calculate measurements while performing surgery to deliver a higher degree of accuracy
Robots, computers, and intraoperative software have become widely used in multiple surgical fields. In March 2019, Dr. Goodwin became the 6th orthopedic surgeon in the United States to use Hip Check, an intraoperative software that removes the human error from estimating bony impingement around the hip. Hip Check (seen above) utilizes live x-ray taken during surgery and delivers a real time quantitative analysis to guide surgical correction of hip impingement, a leading source of hip pain. “With this technology, we precisely remove the right amount of bone in the right area which decrease surgical time, pain, and will improve outcomes,” explains Dr. Goodwin.
Utilizing this technology allows our patients to wake from surgery with significantly less pain
When hip pain comes from labral tears, most patients benefit from physical therapy or intraarticular injections. In patients that continue to have significant pain, hip arthroscopy has been very successful in returning patients to an active lifestyle. In some cases, when the labrum cannot be repaired because it is frayed or split into many small pieces, labral reconstruction is a new option in the hip. “We recreate the labrum using tissue that restores the hip’s normal function” explains Dr Goodwin. “In cases where there used to be no option except to trim back the labrum entirely, leaving a defect, we now have an effective tool to reconstruct this critical area.”
David Goodwin, MD is a fellowship-trained sports medicine physician who specializes in the non-operative and surgical treatment of both youth and adult patients with shoulder, knee, hip, and sports injuries. To schedule an evaluation with Dr. Goodwin in our South Riding office, request an appointment online or call 703-272-5000.