Hip Rehabilitation without Surgery in Israel | Ichilov Hospital

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Dr. Ratt, head of the Minimally Invasive Orthopedics Unit at Ichilov Medical Center and senior lecturer at Tel Aviv University, and his team implement an innovative, unparalleled arthroscopic technique to spearhead a unique hip rehabilitation program, including treatment of damaged cartilage.  The procedure is performed on an outpatient basis with the benefits of a full professional and caring medical support team who accompany the patient through the entire process, until their complete rehabilitation.

The hip is one of the most important joints in the human body and one of the five largest. It plays a central role in our ability to move freely in space and perform three dimensional movements. When the hip joint is injured and cannot properly function, we suffer twofold. The first and most immediate insult is of course physical: functional limitation, which results in loss of movement and the inability to perform daily tasks once taken for granted, when they become painful and require much effort. The second insult is to our emotional wellbeing, with the realization that our restricted mobility means we cannot perform some of the most basic routine activities in our daily lives.

Hip Rehabilitation: Surgery Not Necessarily the Answer Anymore

Busting an Age Old Myth

Some say that injury to the hip joint is irreparable and that complete recovery and return to routine activities is impossible. This myth is rooted in our collective knowledge of various hip pathologies, primarily among the elderly population, which deliver a lethal blow to normal movement patterns and dramatically affect quality of life. However, this is true only for the very aged.

Dr. Ratt, head of the Minimally Invasive Orthopedics Unit at Ichilov Medical Center in Tel Aviv, explains that “the hip joint can be repaired and rehabilitated to its previous condition, so that the patient can once again perform all of the activities that comprised his or her daily routine and contributed to his or her quality of life”. Dr. Ratt has been a pioneer in arthroscopic management of the hip in Israel since 2000, and is a world-renowned expert in his field. His motto is “surgery is a last resort”. In Israel, Ratt leads the global trend which asserts that most hip injuries can be repaired to pre-injury conditions via minimally invasive arthroscopy. The procedure can be performed in an day hospitalization setting in which the patient is discharged on the same day, or on the following day at the latest. In most cases, patients can bear weight on their legs a few hours after the procedure and can fully weight bear without the aid of crutches two weeks later.  Even Professional athletes who place great stress on their hip joints may return to all activities three months after the procedure. 

It’s All About Personalization

In essence, we are poised at the forefront of the most innovative approach to repair and rehabilitate the hip joint. This is personalized medicine at its best–the hottest trend in western medicine in a number of fields. “Our approach”, explains Dr. Ratt, “takes into consideration not only the predicted success of the procedure, but also the patient’s lifestyle and the effect on his or her quality of life. Beyond assessing the condition of the joint and deciding which procedure best suits treatment goals, it is important for me to understand the patient, What is their lifestyle and profession? What kind of stress do they place on the joint? What are their hobbies and leisure activities and what are their functional goals to achieving their pre-injury lifestyle? The patient is a full partner in the process and receives detailed explanations about the nature of the injury and the type of procedure determined to be most appropriate for treatment. I make it clear to my patients that in most cases, recovery and rehabilitation of the joint can be achieved without surgery and that surgery is advised only for those cases where we have identified a mechanical problem that cannot be treated conservatively. The procedure is performed with the support of a highly qualified medical team which includes physical therapists trained in non-surgical hip rehabilitation and post-operative recovery. Alternative therapies, Feldenkreis technique as well as guidance on changing movement patterns and habits, are part of the rehabilitation process, which is closely monitored by a team of professionals throughout the course of recovery until patients regain full functionality. We are uncompromising in our commitment to achieving the best results”.

Experience is Key

Dr. Ratt performs 120 hip arthroplasties per year. The range of problems that can be diagnosed and treated is vast and includes, among others, repair of hip impingement which is caused by a focal bony protrusions on both sides of the joint, repair of the cartilaginous ring that seals the head of the femur in the socket and stabilizes the joint (labrum), repair of hamstring tear including severe tears in which the muscle is detached from its insertion into the bone, and reconstruction of the labrum with repositioning of an adjacent tendon. All procedures are performed arthroscopically via two to three small incisions measuring 5 mm in diameter each. “My main goal”, says Ratt, “is to regain hip functionality and preserve the joint. Obviously, in cases of progressive joint erosion there is no other option than to replace the joint with an artificial prosthesis; however, today it is possible to identify some of the conditions which lead to erosion of the joint early on, halt the degenerative process and in turn, as much as possible, prevent the need for hip replacement surgery. Sometimes, the breakdown of cartilage restricts movement. In these cases, we aim to block this process and if the labrum itself is damaged, we prefer to reconstruct the labrum using a unique method.”
Dr. Ratt and his team have recently published a paper in the prestigious Arthroscopy journal on a new and effective method for pain management following surgery. This method reduces pain significantly in the first 12 hours following surgery, allowing the patient to be discharged only several hours after surgery. 

At the Ichilov Medical Center innovation is a way of life. Here, you’ll find exceptional quality medical care delivered by world-class specialists. Every one of our experts is dedicated to bringing you the best treatment possible while ensuring the highest possible quality of care. You’ll be in safe hands here!

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