Active adults and teenagers who are injured are getting back to their activities more quickly these days because of recent advancements in the tools and techniques that sports medicine doctors are using.

One of those new tools and techniques is an operating table that allows Dr. Michael P. Palmer, an orthopedic surgeon specializing in orthopedic sports medicine at The Christ Hospital Health Network, to more easily and safely move the head of a patient’s femur out of its socket in the pelvis during arthroscopic hip surgery.

The initial techniques for arthroscopic hip surgeries involved a lot of traction and a post on the operating table to distract a patient’s femur out of its socket in the pelvis to give doctors a full view of the hip joint, says Palmer. That technique, which involved a lot of force, could cause complications, including nerve palsy, skin tears, urinary retention and sexual dysfunction, he says.

With the new operating table Palmer is able to use gravity and friction to move the head of a patient’s femur out of its socket in the pelvis to help eliminate those potential complications. “It’s kind of big advancement for us,” he says.

One of the most common indications for arthroscopic hip surgery in young, active patients is femoroacetabular impingement syndrome, an incongruity between the ball of the femur and its socket in the pelvis, says Palmer.

“It affects young, active patients [and] causes activity and positional-related pain, and so people will often say when they are trying to do X it hurts,” he says. That could be a pitcher in baseball who is trying to push off the mound, a soccer player who can’t run and cut anymore or someone who can’t do their workouts at the gym anymore because of hip and groin pain, says Palmer.

The new table is used during arthroscopic surgery to correct the impingement. “It’s an out-patient surgery,” he says. “You come in, you go home the same day. Two or three small incisions on the side of your hip,” Palmer says.

“If you’re an athlete and you’re going back to a sport you usually return to sports somewhere between five and seven months, which is probably about half the time of like an [anterior cruciate ligament] reconstruction,” he says.

Another new technique that Dr. Michael Kachmann, a neurosurgeon with Mayfield Brain and Spine, is using to treat many “weekend warriors” with sacroiliac joint pain is minimally invasive surgery to fuse the sacroiliac joint.

The sacroiliac joints are located where the spine meets the pelvis. Patients often complain of low back pain and doctors at Mayfield Brain and Spine have developed a protocol that can determine if that pain is actually sacroiliitis, a condition where one or both of the sacroiliac joints become inflamed causing pain in the buttocks, lower back and down one or both legs.

A new type of surgery to fuse the sacroiliac joints has been developed in the last two years that can alleviate the pain, says Kachmann. He says the minimally invasive surgery inserts three titanium implants across the sacroiliac joints that cause the joints to eventually fuse together. “And that pain goes away,” he says. “And it could be quite life altering for people to have this.”

Another life-altering technique being used in sports medicine is the way that pain is managed. The University of Cincinnati College of Medicine recently completed a study on its own patients who underwent knee surgery to determine the appropriate amount of prescription opioids to manage post-surgical acute pain.

Dr. Brian Grawe, a board-certified orthopedic surgeon and an assistant professor at the University of Cincinnati College of Medicine, department of orthopaedic surgery and sports medicine, says UC wanted to determine how it could “limit the amount of opioids necessary while still keeping the patient on the road to recovery and not miserable.”

The study was completed because some patients became addicted to opioid painkillers after being overprescribed following a surgery. “They go home from surgery and they get 60 pills and for some people that’s way too many,” he says. “We also don’t want to not give people enough.”

The scientific study included looking at demographic variables and surgery types, says Grawe. “We’ve been able to kind of look at these factors to figure out how to diminish the amount that are prescribed,” he says.

The study found that following knee surgery, depending upon if it was a major or minor surgery, on average patients would have to be prescribed opioids for between five and 11 days, says Grawe.

The study also found that patients had a much higher likelihood of being on opioids longer than that if they had previously taken an opioid, he says. “So that has led me to counsel people at length that if you’ve previously taken [opioids] before we’ve got to do a really good job of staying organized to get you off of them,” Grawe says.

Kachmann says a combination of minimally invasive surgical techniques and a new painkilling drug has helped his patients get off narcotics quicker. The new drug, called Exparel, is injected into the patient’s back following surgery. The drug has a liquid membrane that slowly releases its numbing medication over three days, he says.

“So if you can get past those first few days of surgery you use a significant less amount of narcotics—sometimes even no narcotics because it’s numb for a few days,” Kachmann says. “If I can get through the first few days after surgery with very little pain I’ll take it all day long,” he says.