How Hip Arthroscopy Can Help With Your Pain

Jarrad Merriman, MD, MPH, an Orthopedic Surgeon of Sports Medicine, explains how hip arthroscopy treatment can help those with hip pain.
How Hip Arthroscopy Can Help With Your Pain
Featured Speaker:
Jarrad Merriman, MD, MPH
A California native, Dr. Jarrad Merriman was born and raised in Bakersfield. He graduated from California State University Fresno with his Bachelor of Science degree in biology. He then went on to earn his Master of Public Health and Doctor of Medicine degrees at the Keck School of Medicine of USC in Los Angeles. After medical school, Dr. Merriman completed the exclusive San Francisco Orthopedic Residency Program at St. Mary’s Medical Center, where he learned about all aspects of orthopedic medicine and musculoskeletal surgery over five years of intensive training. Interested in furthering his training and experience, Dr. Merriman came to Southern California Orthopedic Institute in Van Nuys, where he completed a yearlong sports medicine fellowship.
Dr. Merriman is dedicated to making a tangible difference in patients’ lives on a daily basis. When patients
are most vulnerable because of pain, an injury, or accident, he is devoted to earning his patients’ trust to
help see them back to their normal lives. In his practice, his goals are to help patients prevent injuries, return
to activity, get back to work, recover from injuries, reduce pain, and have long-standing relationships that
transcend their condition. As a former athlete, he has had several injuries, which affords him significant
empathy with patients wanting to safely return to competition. He enjoys working as a team with his patients
to help them solve their problems and get back to doing what they love. Dr. Merriman is available to see patients in Bakersfield. When Dr. Merriman isn’t seeing patients, he spends his time
with family and enjoys fishing, hunting, travel, exercise, and golf. His wife, Kellie, is a former nurse, and they have one daughter and two sons. Dr. Merriman has also volunteered in Mexico, China, and most recently, in Africa, working in medical clinics, cardiac research, and orthopedic trauma surgery.
Transcription:
How Hip Arthroscopy Can Help With Your Pain

Introduction: This is Hello Healthy, a Dignity Health Podcast.

Alyne Ellis: Hip arthroscopy is a surgical procedure that allows doctors to view the hip joint without making a large incision. This procedure is used to diagnose and treat a wide range of hip problems. Here to tell us more is Dr. Jarrad Merriman, an Orthopedist at Southern California Orthopedic Institute, which is connected with Dignity Health. Welcome Dr. Merriman, thanks so much for joining me today. So first off, tell us just a little bit about yourself.

Dr. Merriman: My name is Jarrad Merriman and I'm an orthopedic surgeon. I just finished training. I am originally from Bakersfield, California and spent almost last 18 years away from Bakersfield training in different aspects of surgery and orthopedic surgery. Most notably went to medical school down at UFC and spent five years there doing kind of general medical training, and then spend another five years in the Bay area doing general orthopedic training, and then spent the last year in Los Angeles with Scobey and Van Nuys doing sports medicine, specific training. And then now I'm back in Bakersville, back home kind of serving the community where I came from.

Host: So, our topic today is problems with the hip, and maybe we should begin with some of the signs of the most common hip issues. I assume probably the first one for anybody might be pain.

Dr. Merriman: Yeah, you're right. It's kind of a hips and interesting structure because it's so deep and it can be related to thigh or knee or back pain. So it can be pretty vague pain about the hip. It can be associated with activity related pain or pain at rest. Oftentimes people actually see pain when they're sitting for long periods of time, which can put some stress on some of the structures inside of the hip as well.

Host: And one form of treatment and diagnosis for a hip problem is what we're really talking about today. So tell me about hip arthroscopy and how it's done?

Dr. Merriman: Yeah. I think a lot of people are used to thinking about arthroscopy in the shoulder and the knee where they work through small cameras, and now we can do the same thing through the hip. So we put small incisions, usually about one centimeter incisions, approximately two to three of those incisions at the front of the hip. And we put a longer camera into the hip and instruments in the other incisions so we can fix various hip problems about the hip with minimally invasive manner.

Host: How does a procedure like that take and is the patient completely knocked out or what happens?

Dr. Merriman: That's a good question. Yeah. So they're completely knocked out and the procedure takes usually somewhere around two hours. It depends on exactly what we're doing, but I would say on average about two hours and it's an outpatient procedure, meaning they'll come in and leave the same day and it usually doesn't require a hospital stay.

Host: So, in addition to diagnosis one, you can fix something there. What kind of problems can this procedure address?

Dr. Merriman: Good question. The typical problems that we can address through hip arthroscopy are lesions or damage to the cartilage that covers the ball and the socket of the hip. Sometimes you can have loose bodies or it could be chunks of cartilage or soft tissue that are floating around in a hip that we can remove. There's a labrum in the hip, which serves kind of like a gasket in between the bones and the labrum can be torn. So, we can repair that labrum. And there's also something called a cam or pincer Legion lesion, which is overgrowth of the bone over the hip. And we can shave down the bone as well.

Host: So, bearing that in mind, who is a good candidate for this procedure?

Dr. Merriman: So, the best candidates for hip arthroscopy surgery are on the younger end. So less than about 45 years old, that have limited arthritis. And they have, you know, one of these hip problems, you know, diagnosed via MRI. And they're really too young to need a hip replacement, but still have something that's really bothering them that needs surgery.

Host: I know you specialize in among other things, sports medicine, is that for example, something that one might get from a sports injury?

Dr. Merriman: Yeah, it's actually really common in athletes up to 20% of the population has some of these hip related issues. I discussed. And 80% of the athletic population has these issues. It's just, not all of them are symptomatic.

Host: So, I'm assuming that this helps to relieve pain and get people back to their normal activities. So what is recovery like for this kind of procedure?

Dr. Merriman: It depends on what we do. If we're just shaving down a bony area, then it can be relatively quick, you know, on the order of a few months, if we're repairing labrums or doing labrum reconstructions, that can be a longer recovery, three to six months, but generally it's, you know, a good six months before returning to high level activity.

Host: And what about physical therapy? Does the person need to go through that afterward?

Dr. Merriman: Yes. There's a very directed regimen of physical therapy that occurs based on what procedure was performed

Host: And is this procedure performed in a hospital?

Dr. Merriman: They can be, but generally it's performed at an outpatient surgery center. It's good to have a team and equipment that the team is familiar with that does the surgeries regularly. So it just makes it easier on everybody and easier for the patient.

Host: And if you were to get in there and have a larger issue, does that ever happen where then someone has to have something more extensive at that point or by then they've had the MRI and everything else. And so I'm assuming that probably never happens.

Dr. Merriman: Yeah. That has not happened because of what you said. Yeah. We spend a lot of time diagnosing and working the problem up prior to ever getting to surgery, to avoid any sort of surprises. So we know exactly what we're going in for and exactly what we're to do. And it generally proceeds in such a manner.

Host: And I'm assuming the patient goes home that day. Anything else that we need to know?

Dr. Merriman: No, I think it's important to just mention that it falls under the category of hip preservation surgery. So the goal is to preserve a damaged hip in order to possibly avoid a potential total hip arthroplasty or replacement, or the other goal is to prolong the hip so that it potentially can last several more years without needing a total hip. So, you know, if they were maybe going to need a total hip in five years without any intervention, maybe we gave them another five years and they got 10 more years without needing a total hip.

Host: And is this a procedure then that a lot of orthopedics now do?

Dr. Merriman: Not a lot. It's gaining in popularity pretty rapidly because now an orthopedic residency and sports medicine fellowships, it's a part of that training. So you'll see then the younger, the younger surgeons coming out are all fast Island in it. However, it's still relatively uncommon.

Host: Well, thank you so much, Dr. Merriman for joining me today. It's really very interesting. I enjoyed talking.

Dr. Merriman: Yeah. Thanks for having me. I appreciate your time.

Host: Dr. Jarrad Merriman is an orthopedist at Southern California Orthopedic Institute connected with Dignity Health. For more information, please visit dignityhealth.org/Bakersfield/ortho. And if you found this podcast helpful, please share it on your social channels and be sure to check out the full podcast library for topics of interest to you. This is hello, healthy, a dignity health podcast. I'm Alyne Ellis. Thanks for listening.