Kansas City's only boutique orthopedic practice
Dr. Cody Harlan is Kansas City's most experienced arthroscopic hip surgeon having performed more than 3000 advanced arthroscopic procedures of the hip including the surgical correction of impingent (cam and pincer impingement correction), labral repair, labral reconstruction, and capsule repair as well as endoscopic trochanteric bursectomy and abductor repair (gluteus medius and minimus repair).
Hip impingement was first described in 2003. This was not that long ago! Since this first paper was written our recognition of and ability to treat athletic hip conditions has exploded. Hip arthroscopy is probably the most challenging sports medicine condition to treat. Recognition and diagnosis of the problem eludes many practitioners, including orthopedic surgeons themselves. Imaging can be misleading, and the technical demands of the actual procedure itself make hip arthroscopy the most difficult arthroscopic surgery to perform.
Your choice of surgeon is important. Experience is critical. Dr. Harlan has successfully returned all levels of athlete back to their chosen activity. Professional, collegiate, and high school athletes, as well as the weekend warrior. Dr. Harlan is the most experienced surgeon specialized in hip arthroscopy in Kansas City. In fact, He is one of only a handful of Orthopedic surgeons with this level of experience throughout the entire United States.
Conditions about the hip joint can be elusive to correctly diagnose and treat. If you have unexplained hip, buttock, groin, thigh, or knee pain unresponsive to typical treatment, or have had previous hip arthroscopic surgery and are still having symptoms Dr. Harlan might be able to help. If you are in your 20's-40's and have been told you have mild hip arthritis Dr. Harlan might be able to help.
Ahead of your first visit to our Center you will be asked to either bring or have sent your actual X-ray images of your hip. If you have not had recent films our office staff will help direct you to get these. If you have had other studies (MRI/CT, etc.) you will be asked to have these available as well. In the hip, the X-ray images typically tell most of the story so these are critical for putting the entire puzzle together.
Your office visit will be scheduled for 20 minutes. This is 20 minutes with Dr. Harlan, not with extenders, etc. It is common for a patient to have seen multiple other physicians and physician extenders without an answer to their hip problem. Dr. Harlan believes strongly that your time is important, therefore if you take your time to see him, you will see him! During this initial visit Dr. Harlan will go thru an extensive history and exam. If it is clear you have a hip impingement problem with or without documented labral tearing he will explain in significant detail what hip impingement/labral tearing is and how this relates to you. Sometimes more information is needed. For example diagnostic injection to test whether your hip joint is the source of your pain. If so, we have an ultrasound on site that Dr. Harlan will utilize for this.
The day of surgery you will be asked to arrive up to a few hours before your scheduled start time, depending on the surgery location chosen. Dr. Harlan's choice for anesthetic is a spinal anesthetic....yes, a spinal. The addition of a spinal anesthetic has turned this procedure into a nearly narcotic free procedure. You won't remember the spinal being given, nor will you be awake during the procedure itself, but most importantly you won't feel any of the surgery either. This is critical as typically the anesthesiologist has to administer a significant amount of narcotics to essentially dope you up enough so that your brain doesn't care what it is experiencing. With a spinal you are basically taking a nice nap.
The surgery typically takes around two hours....usually 90 minutes of actual surgery and 30 minutes taken to transport you to and from the operating room/positioning for surgery, etc. Dr. Harlan offers both post and post-less traction. He normally utilizes the post for traction as the typical length of time for Dr. Harlan to complete what is necessary with traction is approximately 30 minutes. Post-less traction is often chosen by the more inexperienced surgeon performing hip arthroscopy as their traction times can be significantly longer (approach or exceed two hours). Once the surgery is complete and you are in the recovery room the spinal will slowly wear off. Typically it will be another hour or so in recovery. During the procedure Dr. Harlan places two separate injections that numb the hip and surgical site so when you leave you are alert, have complete control of your legs, and typically very comfortable. Most patients report taking only a few to none of the pain pill prescribed for post operative pain. Of course there are other options for anesthetic and Dr. Harlan can discuss with you the pros and cons of each.
Within a day or so after surgery nearly every patient reports that they are able to tell that the pain they were having prior to surgery is gone. The post surgery hip discomfort is typically completely different than the pre surgery hip discomfort. The surgery is typically well-tolerated. A pain pill will be sent to your pharmacy for post operative pain however for most people they might take a few pain pills and that is all. In fact it is more common in the younger patient (teenage) to not take any pills for pain after surgery. It is also rare for Dr. Harlan to have to refill a pain medication after surgery.
Typically PT is started within the first few days after surgery. Crutches will be needed but Dr. Harlan allows you to begin weight bearing as tolerated immediately after surgery on your operated hip. Most patients will wean from their crutches within the first 10 days or so after surgery. Most patients walk in without crutches at their first post operative visit at roughly 2 weeks after surgery. Dr. Harlan will prescribe a hip brace that you will be instructed to wear during the day for the first month after surgery.
Your post operative recovery is essentially divided into two separate six week sections. The first six weeks you will be working with your therapist/trainer. The second six weeks each scenario is different. For some, formal PT has ended and Dr. Harlan will help navigate you back to your chosen activity. For the athlete, Dr. Harlan typically releases you to begin sport specific activities at the start of month 3 or 4 post surgery.
3 dimensional illustration of cam impingement
3 dimensional illustration of pincer impingement
It is common for patients to travel from a distance to see Dr. Harlan. In fact in 2021 we saw patients from each coast (California and Florida) as well as throughout the central portion of the US (Texas, Oklahoma, Colorado, Nebraska), to name a few. The office is minutes from Kansas City International Airport and thus a short UBER ride away. There are several hotels close by as well, our staff would be happy to help with the all of the details of your visit. Depending on where your surgery is scheduled our staff will also recommend convenient lodging for your stay in Kansas City. Dr. Harlan recommends arrival the day before surgery. If you are within driving distance Dr. Harlan typically recommends that you drive home the day of surgery with a single (most cases) follow up visit one month from surgery. If you are flying he typically will see you the following day in clinic and most of the time follow up can be done remotely with a need to return to Kansas City not typically necessary.
Click the tab to view the typical post-op instructions after hip arthroscopy.
Hip conditions that are treatable are often under-recognized and can cause a patient to have to eventually stop or significantly modify what they love to do. Dr. Harlan has treated many patients that were told there was nothing wrong with them or there was nothing to do or even had unnecessary surgery and their hip condition was missed completely. Most hip conditions are active, younger person problems. If you have hip girdle or surrounding pain that has gone unsolved or is not responding to treatment contact us.
Dr. Harlan has worked with and received training from multiple world renowned arthroscopic hip surgeons, including Dr. JW Thomas Byrd of the Nashville Hip Institute in Nashville, Tennessee.