MAY 3, 2006 | Thanks to a first-of-its kind hip joint surgery performed at the University of Arkansas for Medical Sciences (UAMS) by orthopaedic trauma surgeon Johannes M. Gruenwald, M.D., Rhonda Gomez is walking pain-free.
Gomez’s hip problem developed months after a January 2005 head-on car collision that crushed the 34-year-old
“I was always sore and when I walked something would catch in my hip and it would hurt so badly that I just wanted to sit down,” Gomez said.
Gruenwald, who also rebuilt Gomez’s right ankle, diagnosed her hip problem and determined that she would be an ideal patient for UAMS’ first arthroscopic hip surgery. The minimally invasive surgery replaces the long incision and long hospital stay of traditional open hip surgery.
Gruenwald confirmed through use of an MRI that Gomez’s hip joint contained “loose bodies” of cartilage fragments. The four fragments, sheered away from the joint by the force of the wreck, worked like pebbles in a gear, and they were growing, Gruenwald said.
Such cases traditionally have been treated with open hip surgery, which requires an incision as long as 15 inches, a three-to-five-day hospital stay, post-operative pain, discomfort and disability, and months of recovery.
As a hip and pelvic fracture specialist, Gruenwald knows the hip’s anatomy like the back of his hand, and he is expert in arthroscopic procedures. But the minimally invasive procedure is still rare, unlike the more commonplace arthroscopic knee surgery. That’s largely because the hip joint is much deeper in the body, and major nerves and arteries must be carefully avoided. Being young, active and normal weight made Gomez a good candidate.
“I was waiting for the right patient and needed some time to figure out myself exactly what I wanted to do and how I wanted to go about it,” Gruenwald said.
During the Jan. 23 surgery, using two small incisions and a pencil-sized instrument called an arthroscope, Gruenwald viewed the hip joint through a tiny high resolution TV camera on a television monitor. He also used other surgical instruments through the incisions to remove the cartilage fragments.
“The immediate outcome was stunning; Miss Gomez was walking nearly normally at her first clinic visit, without crutches or a cane,” Gruenwald said.
Gomez was given crutches, but that put too much pressure on her rebuilt ankle, so she decided to walk without them. After surgery she said she was pain free.
“I immediately felt so much better,” she said about a month after the surgery. “I really believe that Dr. Gruenwald cares and that he tried to help me as a person, and I think that’s what everybody wants when something catastrophic happens.”