Dr. Looney is a board-certified orthopaedic surgeon specializing in hip arthroscopy and hip/knee replacement and preservation. He is a member of the International Society for Hip Arthroscopy, the American Orthopaedic Society for Sports Medicine, the American Academy of Orthopaedic Surgery and the Duke University Piedmont Orthopaedic Society.
We recently sat down with Dr. Looney to discuss changes in the field – and hear the story of how his non-medical wife graciously assisted him in the cadaver lab years ago!
WS: What is hip arthroscopy and who may benefit from this procedure?
Dr. Looney: Hip arthroscopy is a minimally invasive way to address soft tissue injuries and bony impingement of the hip through small poke holes. We’re able to address the injury in a less open or invasive way.
It’s commonly a procedure for younger patients, but it’s not age-restrictive. The majority of my patients are in the 16-35 year-old range, but it all depends on what your joint is like and what sort of patient you are in terms of the quality of your hip joint, overall health, and activity level. I’ve operated on people in the last two weeks ranging from age 14 to 61. I also saw this patient yesterday who’s 65 and three months out from her hip arthroscopy. She’s 65, but, as a runner, she’s physiologically more like a 35 year-old and she is recovering like a young patient. In short, we take the patient as a whole and determine if the operation is appropriate for them.
WS: Where did your interest in hip arthroscopy begin?
Dr. Looney: My interest first began with the hip joint when I was a resident at Duke University. In those years, I was working with Dr. Steve Olson on an idea. We were dissecting cadaverous hips to see where impingement occurred.
From 2003 to 2006 I would dissect hips in the cadaver lab and take them to have them x-rayed. My wife and I were joking about this recently because the problem with doing this study was that it was a long walk from the bowels of the cadaver lab to Radiology in the North Suite. So, I would do this research during my limited spare time and vacation.
My non-medical wife would help me and was willing to move cadaver hips across campus. The only thing she complained about was how her scrubs looked on her – never about carrying hips! I knew she would be very resilient and would be a problem-solver. My wife always knew I’d be a hip surgeon, and I always knew she would be my wife.
I also knew I wanted to do sports medicine, but I wanted to do a fellowship that focused on the hip. I did a fellowship from 2006-2007 in Vail, CO, to train under Dr. Marc Philippon, one of the pioneers of hip arthroscopy. At the time, Dr. Philippon was one of the few surgeons who were actually repairing the labrum, the O-ring of the hip socket. During this time, most surgeons were just debriding or removing the tissue—he was fixing it. With the arthroscope, he was also doing a lot of boney contouring, addressing impingement through small poke holes (called portals). I was very interested in learning that from a sports medicine standpoint.
I wanted to take hip arthroscopy to the level of sports medicine through a more minimally-invasive approach, using a camera and small poke holes. After I left Vail in 2007, I came to Nashville and was one of the first in the Southeast to do these labral repairs.
WS: Have there been any recent technological advancements in hip arthroscopy that have changed the quality of care patients receive?
Dr. Looney: There has been a lot of change in the technology of how we repair the hip. We’ve gotten better about mapping out where the hip impinges or makes abnormal contact. We have computer programs that help model the hip. We also have very unique tables that aid in facilitating hip arthroscopy, making it a safer and more reliable operation. Our tools to repair the labrum have also become much better. In terms of the techniques we use to address the problems, they’ve really changed exponentially over the last five to 10 years.
The idea of treating a patient whose labrum is torn beyond repair and rebuilding it entirely was very foreign to many sports surgeons. We’re not just doing repair. We are literally rebuilding the labrum and sewing it into the hip socket. We call this technique a labral reconstruction—actually putting a new labrum. While it was being done in other areas of the country, I believe we were the first to do entire (“pan-labral”) reconstruction in Tennessee and continue to do many of them. Patients older than age 45 actually seem to do better with this approach according to the data. We’re constantly learning in this rapidly evolving field.
WS: How does the collaborative approach of The Bone and Joint Institute of Tennessee help patients receive the best care?
Dr. Looney: The one thing that’s unique about Bone and Joint Institute is that we are only 50-steps-away from each other while problem-solving. Everything is very collaborative here and can be solved just by walking down the hallway. Yesterday, I was working with one of our physical therapists on a particular patient and simply stepped out the door, walked 50 steps and I was in the Rehab Department to collaborate on a physical therapy plan for that patient.
Often in sports medicine, surgery is only one component of treating the patient. The recovery and rehabilitation is just as important – if not more important. That collaboration cannot be understated. We have some of the best therapists in the world at Bone and Joint Institute. That we can work as a team, constantly communicating, is critical.
WS: What do you enjoy most about your work?
Dr. Looney: The thing that provides us with great satisfaction in sports medicine is that before we engage in a procedure with a patient, we ask them what their athletic and fitness objectives are. We ask patients about a hip outcome score and they give us a percentage of how bad they are before they start out. What gives us great satisfaction is to see them go from 10% to 95%. To see those scores dramatically improve as they come to the conclusion of their rehabilitation process is very gratifying.
What we do in orthopaedics is improving quality of life, rather than saving a life. That’s what’s really fun and gratifying to me. I feel very honored to be able to take care of patients in that fashion, and I’m humbled by it, frankly.
Hip Arthroscopy at The Bone and Joint Institute
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