Experience tailored care from a detailed orthopaedic specialist who is committed to your unique needs and to outstanding outcomes. Dr. Pappas is passionate about applying his unparalleled education, training and experience to perfecting surgical solutions for your hip pain. He works collaboratively as an integral part of your medical care team to ensure a comprehensive approach to your healing. From accurately diagnosing his patients to managing their physical therapy, Dr. Pappas guides his patients throughout the process of becoming pain free.
Femoroacetabular impingement (FAI) is a condition in which extra bone grows along one or both of the bones that form the hip joint - giving the bones an irregular shape or other abnormalities. Because the femur (thigh bone) and the hip socket do not fit together perfectly, the bones rub against each other during movement, often leading to osteoarthritis if left untreated.
A hip labral tear is an injury to the labrum, a fibrous ring of cartilage that surrounds the rim of the hip joint socket (acetabulum). The hip suction seal refers to the natural vacuum-like effect created within the hip joint when the femoral head (ball) fits snugly into the acetabulum (socket), aided by the surrounding labrum.
Hip instability can be the result of bony instability due to hip dysplasia. A subtler form of instability, called microinstability, is a more recently described entity that can be present in adult hips and lead to hip dysfunction and pain.
A hip labral repair is a surgical procedure to treat a torn labrum, a ring of cartilage that surrounds the hip joint socket (acetabulum). The labrum plays a critical role in stabilizing the joint, cushioning the hip, and maintaining a full range of motion.
Labral reconstruction involves the creation of a new acetabular labrum when the patient’s native labrum is badly damaged and cannot be repaired with sutures.
Capsular reconstruction during hip arthroscopy is a specialized procedure typically reserved for cases with significant capsular deficiency or damage, such as in revision surgeries or when the native capsule is inadequate, with the goal of restoring the integrity of the hip joint capsule.
Hip arthroscopy is a minimally invasive arthroscopic surgery procedure used to diagnose and treat problems of the hip joint. Two or three small incisions, typically 1/3-inch, are made and an arthroscope — a thin tube with a camera and fiberoptic light — is used to visualize the joint. Specialized instruments are passed into the joint to repair damaged soft tissue, such as a labral tear, or to perform debridement. The advantages of hip arthroscopy compared to open hip surgery and hip replacement include less pain and bleeding, as well as a lower risk of complications such as infection and blood clots. Since the procedure is minimally invasive, you will also be able to return home the same day as your surgery.
How is Dr. Pappas Different?
An accurate diagnosis is key to the success of surgery or other intervention. For example, although hip instability and hip impingement can both cause labral tears and create similar pain, they are not treated in the same way. A proper diagnosis of the root cause of joint pain requires a combination of high-quality imaging coupled with a fine-tuned physical exam and comprehensive medical history.
Dr. Pappas’ doctorate in medical imaging and biomechanics gives him an unparalleled understanding of how the hip joint works and a unique ability to accurately diagnose the source of hip pain. He believes that successfully treating hip pain depends on treating the correct diagnosis – whether pain is due to weakness, instability, impingement, or a combination.
While earning his doctorate in biomechanical engineering at Stanford University, Dr. Pappas completed the PhD coursework in advanced medical imaging, including ultrasound, CT, and MRI. Unlike many physicians who rely on a report from radiologists, Dr. Pappas expertly scrutinizes each x-ray and MRI image himself, using his findings to customize each patient’s physical exam and guide physical therapy.
Not all patients need surgery to alleviate their pain. Sometimes, an accurate diagnosis coupled with lifestyle changes and focused physical therapy is all a patient needs to address their pain. Dr. Pappas is a strong proponent of non-operative measures. Throughout the year, he mentors physical therapists and teaches PT courses. He collaborates closely with a select group of physical therapists to tailor treatments for his patients. Dr. Pappas will typically communicate with a patient’s physical therapist during each clinic appointment.
Physical therapy is the mainstay of nonsurgical treatment. However, PT is often augmented by medications and injections that decrease the inflammatory contribution to hip pain. While cortisone injections often have an immediate effect, Dr. Pappas does not consider them a definitive, long-lasting treatment for most joint injuries. When he chooses to give a steroid injection, it is often to confirm a diagnosis, reduce inflammation that may be preventing adequate rehabilitation, prevent scar tissue formation, or assist in post-operative recovery.
Dr. Pappas utilizes state-of-the-art techniques and injection therapies, including platelet-rich plasma (PRP) and placental tissue. He is currently collaborating on cutting-edge research to apply placental tissue and growth factors to accelerate healing in the hip.
Dr. Pappas also appreciates that some individuals can find pain relief through alternative care providers and works to collaborate with those clinicians, including acupuncturists, chiropractors, and regenerative medicine specialists.
If non-operative treatments are unsuccessful, Dr. Pappas may recommend surgery.
As a former aerospace and biomechanical engineer, Dr. Pappas brings a meticulous approach to his work, especially in the operating room. He thoroughly reviews a patient’s imaging before each surgery, to precisely visualize the three-dimensional shape of an individual’s joint and make surgical corrections down to the millimeter. No two surgeries are the same.
You can take an academic out of school, but you can’t take the love of learning out of an academic.
Dr. Pappas’ surgical technique is always evolving. Although he has been operating for over fifteen years, he continues to perform research, collaborate with other specialists, and learn new techniques to optimize patient outcomes.
Dr. Pappas is a leader in hip arthroscopy, capsular reconstruction, and labral reconstruction. What is hip arthroscopy?
Labral reconstruction is the application of cadaver grafts to replace labral cartilage tissue that is damaged beyond repair. Labral reconstruction is often utilized as part of revision hip arthroscopy, which may be necessary when a hip remains painful after previous hip arthroscopy. It is often the case that repaired labral tissue is degenerative due to wear and tear and encased in scar tissue, causing continued pain that can be addressed by replacing or reconstructing the damaged labrum.
Finally, Dr. Pappas utilizes placental growth factors as an adjunct during hip arthroscopy and post-operatively to promote healing.
After surgery, Dr. Pappas is in frequent communication with his patients and their care team. While in post-operative physical therapy, he will communicate with your physical therapist before and/or after your appointments to collaborate on your treatment and ensure your progress. Dr. Pappas has a remarkably low post-operative complication rate. For example, over his entire career, none of his hip arthroscopy patients has developed a surgical infection.
From diagnosis to post-operative care, Dr. Pappas and his team are committed to the highest quality of care and best-possible outcomes.
Dr. George Pappas of South Carolina Sports Medicine & Orthopedic Center is a sports medicine specialist who treats injuries of the shoulder, hip and knee. He performs advanced surgeries such as minimally-invasive hip arthroscopy for labral repair and reconstruction, rotator cuff repair, meniscus repair and ACL reconstruction.
