Hip Preservation Surgery in Houston, TX
Your hip has carried you through decades of movement, and when it starts to hurt, the last thing it deserves is a rushed solution. Mufaddal Gombera, MD, is dual board-certified in orthopedic surgery and sports medicine and offers hip preservation surgery in Houston, TX. His single goal is to protect your natural hip for as long as possible so you can continue doing what matters to you. Dr. Gombera sees patients at Fondren Orthopedic Group and Texas Orthopedic Hospital, located just south of the Texas Medical Center. If you have been living with hip pain and want real answers about your options, contact the office today to schedule a consultation.
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What Is Hip Preservation Surgery?
Hip preservation encompasses a range of treatment options, including physical therapy, injections, minimally invasive arthroscopy, and bone realignment procedures. The main idea is to repair and work with your existing joint instead of replacing it.
This approach is especially important for people in their 20s, 30s, and 40s who want to avoid or delay joint replacement.
When Is Hip Preservation Surgery Recommended?
Not every case of hip pain requires surgery. Our hip preservation surgeon in Houston begins with imaging and a physical exam, and will talk with you about your lifestyle before making any recommendations.
Surgery is considered when therapy, injections, or changes in activity have not provided lasting relief, or if there is a structural problem that will get worse without treatment. The best results come from treating the hip before the damage becomes severe.
Dr Gombera, MD
What Conditions Can Hip Preservation Surgery Treat?
Hip pain rarely has a single cause, and the right treatment depends entirely on an accurate diagnosis. Dr. Gombera has published peer-reviewed research on hip disorders such as femoroacetabular impingement and labral pathology, and he brings that depth of knowledge to every patient evaluation.
Femoroacetabular Impingement (FAI)
FAI happens when an irregular bone shape causes abnormal contact between the femoral head and the acetabulum. Over time, that friction wears down the cartilage and labrum, leading to pain, stiffness, and reduced mobility. It is one of the most common causes of hip pain in active adults and athletes.
Hip Labral Tears
The labrum lines the hip socket and keeps the joint stable. Tears can come from FAI, trauma, dysplasia, or repetitive motion, and often show up as a deep groin ache, clicking, or difficulty sitting for long periods. Left untreated, they speed up cartilage breakdown.
Hip Dysplasia
When the hip socket is too shallow to properly support the femoral head, it puts excessive stress on the surrounding tissue. Common in younger patients, it reliably leads to early arthritis without correction.
A procedure called periacetabular osteotomy (PAO) is often used to reposition the socket and restore normal joint mechanics.
Avascular Necrosis (AVN)
AVN occurs when blood flow to the femoral head is cut off, causing the bone to break down. Caught early, procedures such as core decompression can slow or stop progression and help preserve the joint.
Caught late, once the femoral head has collapsed, the damage becomes significantly harder to address, and replacement becomes more likely.
Hip Instability and Other Structural Conditions
Some patients come in with snapping hip syndrome, tendon tears, generalized instability, or post-trauma pain.
Cartilage injuries, gluteus medius and hip abductor tears, and athletic hip and groin injuries also fall within Dr. Gombera’s scope of treatment. Each has its own treatment path, but the through line is always the same. Early and accurate diagnosis leads to better outcomes.
What Are the Benefits of Hip Preservation Surgery?
Keeping your natural hip preserves its biomechanics and sensory feedback in ways an artificial joint cannot replicate, and gives you the best foundation for long-term mobility.
For younger patients, avoiding or delaying replacement also matters practically since implants have a lifespan and revision surgeries carry real risks. Most importantly, hip preservation treats the root cause, not just the symptoms. Rather than simply managing symptoms, patients are addressing the underlying structural cause of their hip pain.
What Hip Preservation Treatment Options Are Available?
Our hip preservation surgery expert in Houston uses a full spectrum of treatments, selected based on the diagnosis, severity, and the patient’s individual goals.
Physical Therapy and Rehabilitation
Physical therapy is often the first step, and it goes well beyond general exercise. Treatment targets the specific muscles and movement patterns that support the hip, built around the patient’s diagnosis and functional goals.
Injection-Based Treatments
Guided injections can serve both a diagnostic and a therapeutic purpose, either confirming the source of pain or providing enough relief to make rehabilitation more effective. Platelet-rich plasma (PRP) and other regenerative options may also be considered depending on the clinical picture.
Hip Arthroscopy
Hip arthroscopy is a minimally invasive procedure where a small camera and instruments are inserted through tiny incisions to address labral tears, FAI-related bone irregularities, and cartilage damage.
Dr. Gombera performs hip arthroscopy using three techniques that set his approach apart from standard practice.
Capsule-Sparing Arthroscopy
The hip capsule plays a central role in long-term joint stability. Dr. Gombera uses techniques that minimize disruption to the capsule during surgery, preserving the natural anatomy that keeps your hip stable well beyond the operating table.
This is a meaningful distinction from approaches that require larger capsular openings.
Ultra-Low Radiation Surgery
Standard hip arthroscopy relies on prolonged fluoroscopy, a form of live X-ray guidance, which exposes patients to significant radiation. Dr. Gombera has refined a technique that typically uses only two to three seconds of fluoroscopy per surgery, a fraction of what most procedures involve.
He is currently the only surgeon in Texas performing hip arthroscopy with this approach.
Postless Hip Arthroscopy
Traditional hip arthroscopy uses a perineal post to create the traction needed to access the joint, introducing a risk of groin pain and nerve injury. Dr. Gombera performs postless hip arthroscopy, eliminating the post entirely and reducing those traction-related risks.
He has performed more than 1,000 postless procedures and regularly teaches the technique to fellow surgeons.
Most of our patients go home the same day, return to daily activities within about two months, and get back to sports between four and six months.
Periacetabular Osteotomy (PAO)
PAO is used to treat hip dysplasia by repositioning the acetabulum to better cover the femoral head, reducing pain and slowing the progression toward arthritis. Recovery includes a two to three-day hospital stay, with a return to full activity over eight to twelve months.
How Does Hip Preservation Surgery Compare to Hip Replacement?
The right choice depends on age, the extent of joint damage, and treatment goals. Replacement is highly effective for end-stage arthritis, but implants are not built to last forever, which matters significantly for younger, more active patients who will likely face revision surgery down the line.
Preservation works with the existing joint, retaining natural mechanics and halting damage progression when performed at the right stage.
That said, it is not right for everyone. When cartilage loss is advanced, replacement may be the more practical path. Dr. Gombera makes that call based on imaging, clinical findings, and an honest conversation about what each option realistically offers.
What Is Recovery Like After Hip Preservation Surgery?
Recovery depends on the procedure. After hip arthroscopy, most patients are on crutches briefly, back to daily activities within approximately two months, and back to sports within four to six months. However, timelines vary based on the individual and procedure complexity.
PAO has a longer timeline, with a two to three day hospital stay, crutches for several weeks, and a full return to higher-level activity between eight and twelve months.
Throughout recovery, patients are monitored closely with follow-up imaging and therapy assessments. The surgery sets the stage, but how well a patient engages with rehabilitation largely determines the outcome.
What Sets Dr. Gombera Apart as a Hip Preservation Surgeon in Houston
Dr. Gombera is an orthopedic surgeon focused on hip preservation and complex hip procedures. He has performed over 3,000 hip arthroscopies and completes more than 500 surgeries each year, making him one of the highest-volume hip preservation specialists in Houston. His patient outcomes consistently exceed published benchmarks for hip arthroscopy and labral repair. Volume matters in this field. Orthopedic research links higher surgeon experience to more accurate diagnoses, fewer complications, and more predictable recoveries.
He earned his medical degree at Baylor College of Medicine and completed his orthopedic surgery residency at the University of Michigan. He then finished his fellowship in sports medicine and arthroscopy at Northwestern University Feinberg School of Medicine, training on sports-related injuries of the shoulder, elbow, hip, and knee.
He returned to his hometown of Houston in 2015, joining Fondren Orthopedic Group and operating out of Texas Orthopedic Hospital. He is dual board-certified in orthopedic surgery and sports medicine through the American Board of Orthopedic Surgery.
Dr. Gombera serves as Director of the Hip Preservation Center at Texas Orthopedic Hospital, leading a multidisciplinary team dedicated specifically to non-arthritic hip conditions. The center brings together state-of-the-art imaging, including 3D CT scans and high-resolution MRI, with specialized physical therapy protocols and evidence-based treatment pathways built on the latest peer-reviewed research. His research includes peer-reviewed publications on FAI and labral repair, with presentations at international conferences including ISAKOS and ISHA.
Dr. Gombera also trains the next generation of orthopedic surgeons, working with fellows and residents from Houston Methodist Hospital, UTMB, and the University of Houston. He also serves as a Clinical Assistant Professor and Teaching Physician at UTMB. Surgeons who teach at this level are held to the standard of explaining and defending their methods to other physicians, an accountability that carries directly into patient care.
He has served as assistant team physician to the Chicago Cubs, Chicago Blackhawks, and Northwestern University football team, and currently holds that role at Texas Southern University.
Dr. Gombera grew up in Houston, tore his own ACL playing football at Memorial High School, and understands firsthand what it means to want your body back.
Traveling to Houston for Hip Care
Patients come to Dr. Gombera from across the country and internationally, often after struggling to find a diagnosis elsewhere or being told their only option is replacement. Before you make the trip, his team can review your MRI and imaging remotely so you arrive with a clear picture of your options.
Appointments are coordinated to reduce the number of visits required, and your recovery plan accounts for the logistics of getting home. If you are coming from outside Houston, reaching out for a remote imaging review is a reasonable first step.
Frequently Asked Question
What Conditions Can Be Treated With Hip Preservation Surgery?
The most common include femoroacetabular impingement, labral tears, hip dysplasia, and avascular necrosis. Cartilage injuries, gluteus medius and hip abductor tears, and athletic hip and groin injuries are also treated. Snapping hip syndrome, hip instability, and certain tendon injuries around the joint can also be addressed. Dr. Gombera evaluates each case to determine the most appropriate approach.
What Is Femoroacetabular Impingement (FAI)?
FAI occurs when an abnormal bone shape at the hip joint causes friction during movement, gradually damaging the cartilage and labrum. It is one of the most common conditions Dr. Gombera treats and a frequent focus of his research.
How Do I Know if I Need Hip Preservation Surgery or Hip Replacement?
It depends on how much cartilage remains and what causes the pain. Patients with a structural diagnosis and intact cartilage are usually good preservation candidates. Those with advanced arthritis typically need replacement.
Does Dr. Gombera Work Out of a Dedicated Hip Program?
Yes. Dr. Gombera serves as the Director of the Hip Preservation Center at Texas Orthopedic Hospital, a program built around the diagnosis and treatment of non-arthritic hip conditions. Patients benefit from a team that works together on hip cases specifically, rather than a general orthopedic setup.
Hip Conditions We Treat
- Hip labral tears
- Femoroacetabular impingement (FAI)
- Hip instability
- Cartilage injuries of the hip
- Gluteus medius and hip abductor tears
- Snapping hip
- Athletic hip and groin injuries
Contact Our Office Today to Schedule Your Appointment
If a structural issue causes your hip pain, it usually will not go away on its own. Waiting too long can make treatment options more limited. Dr. Mufaddal Gombera offers hip preservation surgery in Houston, TX. Call to schedule your consultation or book your appointment online.