The Benefits of Arthroscopy for Hip Surgery

It will be interesting to see how U.S. sprinter Tyson Gay fares at the upcoming 2012 London Olympic Games. Based on his 100m race win at the London Grand Prix last Friday, it looks like he has recovered well from hip surgery last summer and is ready to challenge his key rivals. I wrote this story about arthroscopic hip surgery for a common hip problem last fall for GE Healthy Outlook.

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The world’s second fastest man, U.S. sprinter Tyson Gay, recently had arthroscopic hip surgery to correct impingement, a common hip problem that causes pain and can lead to osteoarthritis. Gay, 29 years of age, hopes to resume training early this fall to prepare for a showdown with Usain Bolt in the 2012 London Olympic Games.

Femoroacetabular impingement, or FAI, develops when there is a mechanical mismatch between the ball and socket sections of the hip joint. The femoral head develops into an egg shape rather than a ball, so it rubs against the socket in an irregular way, causing pain and damage to the cartilage and socket rim. People with FAI can experience limited flexion of the joint, pain when sitting, groin pain or interior hip pain.

Bryan Kelly, MD, Co-Director of the Center for Hip Pain and Preservation at the Hospital for Special Surgery in New York City says, “Some people are born with a genetic predisposition to develop FAI or it can develop over time, particularly among young athletes doing sports that require a lot of rotation through the hip joint. During the early teen years when bones are growing, extra load on the growth plates in the hip can cause remodeling to occur, producing an aspherical shape that no longer rotates smoothly in the socket.”

The Benefits of Arthroscopy for Hip Surgery

Kelly and another surgeon at the Hospital for Special Surgery compared surgical results for 60 male patients, all under the age of 40, and found that arthroscopy performs as well as open surgery to restore the mechanical range of motion for most cases of FAI. Their study is the first to compare mechanical outcomes and was recently published in The American Journal of Sports Medicine. Previous studies found that arthroscopy performs as well as open surgery for improving FAI symptoms, and can return athletes to their chosen sports in about half the recovery time.

Here’s how they did it: Kelly treated thirty FAI patients with arthroscopy, a minimally invasive technique where the surgeon inserts a camera tube into a small incision, and performs joint repair through other small incisions while referring to a video screen. His colleague, Ira Zaltz, MD, treated thirty other FAI patients using the open surgery technique, which requires a larger incision and more invasive procedures. Both surgeons sculpted or recontoured ball and socket sections to make them fit together smoothly, and repaired any existing cartilage damage. Radiographic images were taken before and after surgery; Kelly and Zaltz then evaluated and compared mechanical performance and range of motion by measuring the roundness of the femoral head and the degree of separation between the femoral head and the edge of the socket.

The CDC says that 1 in 4 people may develop painful hip arthritis over their lifetime. Kelly reports that in the U.S. there are 350-400,000 hip replacement surgeries done every year and about half of those patients require surgery to treat osteoarthritis that developed as a result of FAI. The ideal candidate for FAI arthroscopy is a young athlete, 15-25 years of age, without any significant cartilage damage in the hip joint, although Kelly says he will operate on someone up to the age of 50 if they have little other damage and are in good health. The earlier FAI is corrected, the better to prevent long-term damage to the hip joint.

CONNECT THE DOTS:

Learn more about the Hospital for Special Surgery in New York City, where more knee replacements and hip surgeries are performed than any other hospital in the U.S. Read a story about a young adult soccer player who had hip arthroscopy to address FAI. Learn more about hip osteoarthritis on the CDC site. You may also like this post: Advances in Knee Replacement Surgery for Active Baby Boomers.

Originally published on GE Healthy Outlook, October 12, 2011. Copyright Jane Langille.

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