Hip Preservation Specialist Treating Patients in Houston, TX

The hip is a ball and socket joint comprising of the femur (thigh bone) and the pelvic bone. The head of the femur (ball) articulates with a cavity (socket) called the acetabulum in the pelvic bone. To facilitate smooth and frictionless movement of the hip joint, the articulating surfaces of the femur head and acetabulum are covered by spongy articular cartilage. Injury, wear-and-tear and certain diseases can result in the wearing away of the cartilage tissue, causing painful rubbing of bones. Hip replacement surgeries have long been the choice of treatment, where the damaged parts of the joint are removed and replaced with a prosthesis. However, in young active patients, the prostheses are highly prone to wear-and-tear, and the need for repeat surgery. Hip preservation is a surgery that overcomes the limitations of joint replacement.

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    Hip Preservation surgery
    • Periacetabular osteotomy: Periacetabular osteotomy is a surgical procedure to treat hip dysplasia. This involves cutting the acetabulum from the pelvic bone and repositioning it with screws to allow for a better fit of the femoral head. The procedure reduces pain, restores function and prevents further deterioration of the hip joint, thereby increasing the life of the hip joint and postponing total hip replacement.
    • Surgical hip dislocation: Surgical hip dislocation is a surgical technique that involves the dislocation of the hip joint during surgery to facilitate easy access to the inside tissues of the hip joint. It helps your surgeon to clearly view and treat abnormalities present deep into the hip joint.
    • Femoral osteotomy: An osteotomy is a surgical procedure that involves cutting and reshaping of a bone. The femur is cut at the end close to the hip joint and realigned so that it forms a normal angle. This improves the distribution of force placed on the joint and prevents wear-and-tear of the cartilage.
    • Hip arthroscopy: Arthroscopy, also referred to as keyhole or minimally invasive surgery, is a procedure in which an arthroscope is inserted into a joint to check for any damage and repair it simultaneously. Hip arthroscopy is a surgical procedure performed through very small incisions to diagnose and treat various hip conditions.

    The various hip preservation surgeries for severe hip pain and dysfunction in young and active patients have been found to be beneficial, and also avoid or delay the need for hip replacement surgery.

    We often associate hip dislocation and subluxation with older people, but people of any age can have a dislocated or injured hip. A total hip replacement usually works just fine for older and less active people. However, younger people, especially younger athletes, can wear down a prosthetic hip.

    When a replaced hip gets too damaged, the patient needs another surgery. Hip preservation works as an alternative to hip replacement. If you take part in frequent physical activity, it may suit you the best out of your treatment options. Dr. Gombera provides hip preservation treatments to patients in Houston, TX.

    What Is Hip Preservation?

    We call the hip a “ball and socket” joint because the bones included in it fit together like a ball and socket. The head of your thigh bone connects to a socket in your pelvis. Smooth, slippery cartilage lets the joint move without the bones touching each other. However, injuries, diseases and genetic conditions can cause this cartilage to wear away. When the cartilage disappears, the bones painfully rub against one another. Professionals call this condition osteoarthritis.

    In this situation, medical professionals often choose hip replacement as their treatment approach. During hip replacement, the doctor removes the damaged parts of the joint. They then replace them with a prosthetic joint that doesn’t have rubbing bones. However, prosthetic hips get damaged easily from constant physical activity. When the patient is under age 45 or does intensive athletics, the hip prosthetic needs frequent maintenance to work properly.

    Hip preservation lets the doctor and patient delay or avoid hip replacement. An orthopedic specialist provides hip preservation treatment before the cartilage wears away. By addressing the problem before it gets worse, the doctor preserves cartilage and relieves your pain. An orthopedic specialist like Dr. Gombera may recommend a wide variety of treatments meant to preserve the hip. Some patients don’t need surgery at all, while others may have to have minimally invasive or open surgical procedures. Dr. Gombera will work with you to find the least invasive treatment possible.

    Can I Avoid Surgical Hip Preservation?

    Dr. Gombera values first-line treatments that let the patient avoid surgery. While surgery certainly has its merits, your body can often do a better job at repairing your hip when it receives some help. Before he considers surgical procedures, he will try approaches like:

    • Resting the affected area
    • Avoiding certain types of physical activity
    • Creating a physical therapy plan
    • Prescribing anti-inflammatory medication
    • Injecting corticosteroids for pain relief

    These treatments reduce your pain symptoms and make it easier for your hip to heal naturally. Sometimes, hip discomfort comes from temporary conditions that simply need a little extra care. Dr. Gombera does not want to put patients in surgery if less invasive strategies will work.

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    How Does Hip Arthroscopy Work as Hip Preservation Surgery?

    If your hip does need surgical treatment, Dr. Gombera may recommend hip arthroscopy. This minimally invasive procedure limits the impact on your body as much as possible so that you can recover quickly. Instead of making a large incision into your hip, Dr. Gombera creates small incisions. A technologically advanced tool called an arthroscope goes in to show the inside of your hip. It uses a small camera to project a video of your hip on a screen, so Dr. Gombera doesn’t need to see it directly.

    Dr. Gombera then uses thin instruments to remove excess bone, clean damaged tissue and remove cartilage fragments. After the surgery, you have to take good care of the incision and follow a physical therapy plan. You might receive this surgery if you have a hip impingement or a tear in your labrum.

    What Happens During Surgical Hip Dislocation Treatment?

    When an arthroscopy can’t resolve your hip issue, Dr. Gombera might try surgical hip dislocation. This open surgery involves temporarily dislocating the hip so that the surgeon can get to the tissue inside the socket. That way, they can clearly see the problems going on with your hip and take care of them effectively.

    Dr. Gombera will take the utmost care when he separates a patient’s hip joint. He will remove a small piece of bone so that your blood vessels and muscles stay intact. Once he finishes the procedure, he’ll put your bones back together securely with screws. When you have a highly trained professional like Dr. Gombera handle your surgical hip dislocation, you have nothing to worry about. You might need this procedure if you have:

    • A labral tear, or damage to the thick cartilage tissue on the inside of your hip socket
    • Damage to the thin cartilage on the surface of your hip joint
    • Hip impingement, a condition where extra bone causes rubbing and cartilage damage
    • A fracture in the head of your thigh bone
    • Perthes disease, a childhood condition that can deform the shape of the hip
    • Dysplasia, a condition where the hip socket doesn’t fully cover the head of the thigh bone


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    What People Say

    Always has a smile on his face, extensive knowledge in orthopedics and a conservative approach to treatment. Would highly recommend.

    Anthony Sakr

    Excellent Doctor, he treats you very well and all the studies are done quickly. Right now I am seeing him for various diseases and I can recommend him 100%.

    Leticia Alanis

    Dr G was great. He listened to my concerns, explained my condition, and made recommendations that made sense.

    David Behen

    Dr. Gombera was very knowledgeable and explained everything so that I understood. I will see him in the future if needed. Great experience here.


    Dr Gombera was very attentive to my concerns and trying to find solutions. Felt very comfortable with his plan and insights with my possible hip issues.

    Jill Ganse

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