Athletes chant "hip, hip hooray" for the latest in hip surgery

2014-11-18 11:32:26 by Dr. Joe Congeni - Director of Sports Medicine, as posted on the inside.akronchildrens.org blog.

Hip Arthroscopy Hip Arthroscopy

There’s a hot new trend in hip surgery called hip arthroscopy that's helping athletes avoid hip replacements later in life.

A player’s hip can wear out prematurely, especially those who put a lot of rotational stress on it during play. The scope is designed to clean out spurs, bony prominences and other things to avoid complications down the road.

Last week, I had the chance to speak with WAKR morning show host Ray Horner about this popular surgery. We’re seeing many athletes, such as Alex Rodriguez and Chase Utley, jumping on this bandwagon at an early age.

The good news is it’s a relatively simple surgery, so the complications and recovery time are minimal.

Below is an audio file and transcript of our discussion.  Originally aired on 1590 WAKR-AM on Nov. 12, 2014.



DR. CONGENI: I wanted to talk today about one of the hottest, newest things. … It kinda shows you the other side of the spectrum, and we’ve come a long way in this. This is even hard for us in sports medicine to understand. The hot new surgery in sports medicine now is called hip arthroscopy.

And, in the last 5 or 10 years, you’ve seen a lot more, Alex Rodriguez (of the New York Yankees), Chase Utley (of the Philadelphia Phillies), a lot of other players, Tim Thomas (a free agent hockey player) and others, that have this hip scope, and younger athletes, too.

We used to be like, oh my gosh, we’d never do a hip surgery on a kid, and what ended up happening is there’s this condition in athletes where they put so much rotational stress on the hip, it starts to wear out prematurely.

Dr. Joe Congeni Dr. Joe Congeni

If you catch it early on when they’re in their, oh my gosh, teens and 20s, they can do a surgery to shave off some of these bony projections with the two bones, the ball and socket rubbing against each other, through a scope — a relatively simply surgery.

If you let it go, and you pick that person up at 35 when they have bone-on-bone arthritis, what’s the only surgery to do? Hip replacement.

There were so many hip replacements on old athletes, people started to look back and say, “Hey, isn’t there something we can do when they’re younger?

So, most of my career is trying to keep people away from surgery.

HORNER: Yeah.

DR. CONGENI:  Catch ‘em early on, do therapy, do things to keep them away from needing surgery ever. But, this is a case here they’re coming and telling us, it’s a relatively easy surgery. It’s a scope.

We have a couple of surgeons in our town, one doing ‘em in adults, one doing ‘em in kids — pediatric, teenage patients.

Particularly dancers, but also football players, baseball players that get this loss of range of motion, pinching, bony prominence, spurs and things, tearing of the labrum of the hip.

And now, they’re telling us that doing the simple surgery at age 15, 18, 25 is a lot more preferable than waiting ‘til the hip is worn out at 35 and 40 where there’s no other choice but a hip replacement.

HORNER: What are the complications of this surgery? Doesn’t sound like many.

DR. CONGENI:  It’s not really many. It just takes a lot of training, and so as of 5 years ago, there was nobody in our town . Even in what a great town we have orthopedically and musculoskeletal, we had to send people out of town.

Now, I told you we have surgeons who do it. It’s a scope. It’s a very short recovery time. It’s not a big deal.

The problem is to work it up, X-ray doesn’t show a lot of these changes, so very frequently in these kids where we think they’re starting to get this pinching or impingement, we call it, we have to go to an MRI to see how bad the lining of the bone is getting to be.

HORNER: It’s interesting you bring up the hip replacement. I had a friend, he’s one year older than me, who had to have hip-replacement surgery down in Florida.

I said, “Joe, how long has this been bothering you?”

He said, “Well, you know, I’ve had arthritis in there. I’ve had a tough time the last 3 to 5 years.”

He went with this new procedure — and I’m not a doctor, I’ll let you expand here — but he was up and about in like 36 hours and he’s already out playing baseball again. He’s a pitcher in an adult league in Florida. It was amazing. He said it was a new hip-replacement procedure.

DR. CONGENI:  A new type of hip replacement.

HORNER: Are you familiar with that, Joe?

DR. CONGENI: Yeah. There’s always new technology to expand and progress. And there are some newer techniques that are being done as to where the incision is and what we’re using as far as the new hips. …

HORNER: How far we’ve come, huh?

DR. CONGENI:  We’ve come a long way, and that’s part of the technology of this thing. So, hip replacements aren’t quite as terrible as they used to be.

But, the problem is we generally say a hip’s gonna last you 20 or 25 years. What do we do with really young people at 40 who get their first hip?

HORNER: Yeah.

DR. CONGENI: Many of them are living to be 60, 70, 80, 85, 90. Oh my gosh, when you take that hip out and have to do a revision then, now you’re talking about a lot bigger deal.

So, in hips, we’re talking about thinking early on doing something, rather than everybody having to go to replacements later on.

HORNER: Yeah, and I was talking to some people who were having some problems with their hips and they say, “Well, I’m trying to hold off 5 to 10 years because they last 20 to 25 years.”

 

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