Hip preservation: The last frontier of orthopedic surgery
When you think of someone needing hip surgery, healthy and active people in their 20s or 30s probably don’t spring to mind.
But labral tears — when the cartilage around the hip joint socket is damaged — can happen to anyone. Hip preservation surgery is one treatment that can help a young person get back to their active lifestyle.
William Gross, 23, and Malinda Eichner, 39, are two such examples.
“I see hip preservation surgery — such as minimally invasive hip arthroscopy — as one of the last frontiers of orthopedic surgery,” says MultiCare orthopedic surgeon Linnea Welton, MD. “It helps those with hip pain, who are usually between the ages of 20 and 40, and William and Malinda fit right within that range.”
Ending a college baseball career pain-free
Gross, who played shortstop for the University of Puget Sound baseball team, began feeling groin pain in the spring season of 2021.
Gross playing baseball for the UPS Loggers
“I’ve been an athlete all my life and had never been injured,” says Gross. “I figured it was a muscle strain that would eventually get better.”
When the pain didn’t subside, Gross was examined by college trainers, who referred him to Dr. Welton.
“Dr. Welton knew right away what I was going through,” recalls Gross. “After an X-ray and MRI, she recommended surgery.”
Gross discovered he had been born with hip impingement on both sides. Impingement occurs when the bones of the hip joints aren’t shaped correctly, so they rub against one another.
“Some people can go their whole lives and not experience pain, but the impingement caused my labrum to tear on both sides,” Gross explains.
Athletes who play sports that involve twisting and pivoting motions (like baseball) are at a higher risk of developing these tears.
Gross and Dr. Welton discussed timing for his surgery so he could return to play.
“We had a couple of conversations about timing,” says Dr. Welton. “A patient’s life and goals come into play when we talk about management strategies.”
Gross had his surgery in fall 2021, so he was able to recover and get healthy for the following spring season.
Dr. Welton performed hip arthroscopy, where she repaired the labrum and shaved off extra bone growth to help prevent another tear.
“The goals of surgery are to reduce symptoms, prevent progression of arthritis and the chance of retearing the labral tissue, and get people back to the activities they can’t currently do,” says Dr. Welton.
Gross knew there was a possibility of surgery in the future for the other side, but he didn’t expect it would happen sooner rather than later. During spring season 2022, he experienced muscle soreness on the side that hadn’t been repaired.
Nearly a year to the day after his first surgery, Gross underwent surgery on his other hip.
“It was awesome to be able to get back and play my senior year and end my college baseball career pain-free,” says Gross.
New mom regains mobility after hip injury during childbirth
Another less common cause of labral tears is traumatic injury. Eichner’s tear occurred during childbirth.
“After I gave birth to my son, I couldn’t walk without crutches. I couldn’t sit or stand for long periods of time either,” Eichner explains. “I didn’t know what had happened.”
Eichner turned to physical therapy, which brought her to about 60 percent function. She also tried platelet-rich plasma injections. However, these treatments didn’t get her to where she wanted to be physically.
“I enjoy exercising, hiking, dancing,” she says. “And traveling is my favorite thing. Sitting in a plane was out of the question. It was depressing to think about all the activities my body no longer allowed me to do.”
She also worried about not being able to chase her son around once he became mobile.
It was at this point she realized she was going to need surgery to live the life she wanted to live and be the mom she wanted to be.
“Before surgery, I was afraid I wouldn’t be able to do anything anymore. And now, I’m more active than ever.”
She was initially referred to a surgeon who didn’t perform the type of surgery she needed, so she was referred on to Dr. Welton.
Like Gross, Eichner found out she had been born with hip impingement, and she also had a stable form of borderline hip dysplasia. Eichner underwent arthroscopic surgery on her left hip.
“While both Malinda and William had hip arthroscopy, each surgery was nuanced based on their specific hip profile,” explains Dr. Welton.
Eichner has the same anatomy in her right hip, so she says she needs to be cautious about it happening there.
“Usually what causes it to happen is extreme extension of the hip you see in rock climbing or gymnastics, so I’m going to try and avoid those types of activities,” she adds.
At about two months post-surgery, Eichner could walk without crutches.
“I was so impressed with Dr. Welton and her team — everyone was exceptional and on top of their game,” she says. “They were also very personable and seemed to really care.”
A new lease on life
Gross says he’s grateful for finding Dr. Welton, who helped him get back to his final two college baseball seasons.
He received his bachelor’s degree in exercise science this past spring and plans to get his master’s in teaching. His near-term goal is to become a high school teacher and coach baseball.
“My big dream,” he adds, “is to become a baseball coach and make coaching a career. I think teaching will give me the skills to achieve that dream.”
Eichner snowshoeing in the Cascades.
As for Eichner, she says she’s feeling great and has a new lease on life.
“My son is very active, and I’m able to keep up with him and then some,” she says. “Before surgery, I was afraid I wouldn’t be able to do anything anymore. And now, I’m more active than ever.”
In fact, she’s line dancing, snowshoeing, cold plunging once a week and running — with the ultimate goal of completing a marathon.
“I like to see how this chapter has closed for my patients and what they’ve moved on to, now that they’re living without pain,” says Dr. Welton. “It’s great to see them both doing so well.”
