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York Hospital and Dr. Tyler Welch of Atlantic Orthopaedics & Sports Medicine are pleased to introduce The Pivot Guardian System to the York Hospital Surgery Center. The Guardian System is specifically designed to mitigate complications during hip surgery, as it limits the amount of force applied to a patient’s hip. The Guardian also enables the surgeon to obtain better visualization of the hip during surgery compared to other operating tables, and to make precise range of motion adjustments. The system’s boots enhance patient comfort and safety during hip surgery.

Dr. Welch said, “The most common complication of hip arthroscopy is nerve irritation in the groin. The advantage of the Guardian hip arthroscopy table is that it allows me to position the patient optimally, which eliminates the risk o

f nerve irritation. I am the first surgeon in New England to use the table, and I am very excited to bring the newest, most advanced hip system to the York Hospital community.” The demand for hip arthroscopy is increasing every year, and surgeons in the United States are projected to perform 271,000 hip arthroscopy procedures by the year 2021. This will be a compounded annual growth rate of 18.5 percent, compared to a 3.9 percent projected growth in shoulder arthroscopy and 1.6 percent projected growth in knee arthroscopy by the same year.

Hip arthroscopy is a surgical technique in which conditions in the hip can be treated with small incisions, similar to knee arthroscopy and shoulder arthroscopy. During surgery, a small camera is inserted into the hip, providing the surgeon with a circumferential view of the hip. The surgeon uses other small devices to perform a given procedure. These procedures are designed to preserve existing structures; this type of surgery is therefore called “hip preservation surgery.” During total hip replacement, on the other hand, the hip is replaced, usually with metal and plastic implants. Hip preservation surgery can restore function and potentially give patients the ability to remain active and pain-free. Dr. Welch has performed 65 hip arthroscopies since 2015. During surgery, the most commonly treated condition is called femoro-acetabular impingement (FAI). Patients with FAI have abnormal bony structure, and the femoral head (ball) interacts abnormally with the pelvis (cup).

This condition can cause damage to the articular cartilage and labrum in the hip, two structures that are key for proper hip function. During surgery, Dr. Welch preserves the labrum by repairing it and also preserves the cartilage if possible. In patients with severe damage to the labrum, the labrum can be reconstructed instead of  repaired. The bony femoral head and pelvis can also be re-contoured to help protect the hip