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03/11/2020

Correcting hip instability. Dr. Nicolás Fiz presents his hip ligament surgical technique to solve this problem

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Nicolás Fiz, doctor of the Arthroscopic Surgery Unit of Dr. Mikel Sánchez (UCA, according to the Spanish acronym), is the author of the innovative hip ligament surgical technique, a technique we have been applying for years at the UCA and the one that allows solving hip instability. This technique is been well received in the congresses it is being presented in and it is currently in the final publication process.

What is it about?

The hip is a particularly stable joint and dislocations occur just when a severe trauma takes place. However, there is a patient's condition known as hip hypermobility, that is, an increase in the range of motion of the joint. This can occur due mainly to two reasons: a congenital laxity of the joint ligaments; or an injury to these ligaments, usually produced after a previous hip surgery where these ligaments were injured.

Symptoms

Hip hypermobility or micro-instability usually produces pain, mainly when a forced hip extension occurs (for example, when walking fast, the patient feels pain when the affected leg is left behind during the long stride).

How can it affect the future of the joint?

Apart from pain, hip micro-instability can lead, in the long term, to an injury to the articular cartilage. Alteration in the distribution of loads on the joint, with supercharged small areas, can lead, always in the long term, to articular cartilage damage, leading to joint deterioration and increased pain.

How to correct it

Strengthening the muscles that surround the hip joint can lessen the negative effect of the absence or the lack of the function of the ligaments, which can be achieved thanks to specific physiotherapy programs. If this fails, a surgical intervention is the solution.

What does the surgery consist of?

The surgery consists of reconstructing (if injured) or reinforcing (if very lax) the main ligament of the hip joint, that is, the iliofemoral ligament. We have developed an arthroscopic technique to strengthen this hip ligament, just as we repair the knee cruciate ligament. Using a tendon from a donor, the iliofemoral ligament is reinforced, restoring its function and thus eliminating micro-instability and pain.

Dr. Fiz joined Dr. Mikel Sánchez's Arthroscopic Surgery Unit and the Biological Therapy Unit in 2008, taking part in the innovation of different surgical techniques and being the co-author of several publications. In 2009, together with Dr. Jorge Guadilla, he created the Hip Unit within the UCA. Throughout his professional career he has participated as a speaker in various conferences and scientific meetings. He is the co-author of several internationally recognized works. He is a member of SECOT, Sociedad Española de Cirugía Ortopédica y Traumatología [Spanish Society of Orthopedic Surgery and Traumatology].