Stemcelldoc's Weblog

August 25, 2010

Total Hip Replacement Avoided: Diagnosis is Critical

Hip pain can be quite disabling affecting a patient’s level of activity and quality of life.  An accurate diagnosis is essential.  At the Centeno-Schultz Clinic we are committed to identifying the source of a given patient’s pain so that an appropriate treatment plan can be established.

TM is a very active 78y/o patient with a 3 year history of left hip pain which was intermittent in frequency, 8/10 in severity, progressive in nature and localized along the outside aspect of the hip with radiations into the outside aspect of the knee.  Aggravated factors included walking and descending stairs whereas alleviating factors included rest and NSAID’s.  TM had undergone PT, chiropractic care and x-ray guided injection of steroid into the hip.  He was interested in the Regenexx procedure where a patient is able to use their own mesenchymal stem cells.  He rejected both his PCP and orthopedic surgeon’s recommendations for total hip replacement.  Escalating pain forced TM to reduce his activities and one of his true passions: golf.

Physical examination was significant for very limited flexion and extension of the lumbar spine, left leg limp, weakness in the left foot with diminished sensation to light touch and temperature.  Left hip did have mild restriction in range of motion and minimal pain. I was concerned about the radiating character of his pain along with abnormal neurologic examination.  MRI of the lumbar spine was obtained and was significant for multiple level degenerative disc disease, nerve root irritation and narrowing of the central canal (stenosis).

TM did not undergo stem cell therapy because his left hip pain was arising from his lumbar spine.  This was confirmed with a 1 cc injection of local anesthetic into the specific area in his pain.  TM returned today after three x-ray guided injection of platelet derived growth factors into the lumbar spine.  He reports 100% reduction in left hip pain and improvement on his short game.

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