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Hip arthroscopy is not just for professional athletes

A black man and woman run on the dock of a lake. Robert Trasolini, MD, explains why hip arthroscopy has become an option for everyday athletes.

The minimally invasive procedure has become more prevalent among younger people, slowing arthritis and eliminating future risk of hip replacement

While Alex Rodriguez’s tumultuous tenure with the New York Yankees was polarizing, one undeniably positive aspect of his time in pinstripes was his return from hip arthroscopy.

Back then, the procedure was considered radical, but had a significant upside. Mr. Rodriguez had a torn labrum and bone impingement, which a two-hour procedure corrected in 2013. After a six-month recovery and season-long suspension (another story), he had 33 home runs and 86 RBI to earn consideration for Major League Baseball’s Comeback Player of the Year Award.

It was a similar experience for Olympic sprinter Tyson Gay, who competed in the 2016 Rio Summer Olympics after hip arthroscopy fixed a torn labrum, and Washington Capitals sniper Nicklas Backstrom, who has tallied more than 70 points each season since having the procedure in March 2015.

Hip arthroscopy has worked for these professional athletes. And as advancements in technology have improved early diagnosis for orthopedic issues, it’s also becoming a solution for younger people who endure hip pain.

A growing need

Ten years ago, if a 16-year-old — or even a 30-year-old — complained of hip pain, they would’ve been told that they just hurt a muscle and would be fine. They wouldn’t need a follow-up visit.

Today, during a revitalized culture of biomechanics, we can analyze bone and muscular anatomy to drive treatments. We can accurately evaluate if hip pain is something that needs to be attended to in a timely fashion or contemplate a reduction in athletic activities.

Given this new wave of imaging and diagnostic expertise, the number of hip arthroscopies will surely continue to increase exponentially. Why? Because we can now identify issues faster and earlier in life. Fixing these issues earlier can decrease incidence of arthritis and the need for hip replacements, which nearly doubled among inpatients over the age of 45 between 2000-2010.

Hip pain typically occurs with labrum or impingement issues. Arthritis has yet to set in, but could be in the future. That’s where hip arthroscopy comes in.

What it entails

Hip arthroscopy was refined in the late 1980s and early 1990s. Arthroscopic surgical equipment continued to improve, providing surgeons with the capability to treat conditions with minimally invasive techniques.

During hip arthroscopy, an arthroscope (small camera) is inserted into your hip joint. Surgeons make three, small, 1-centimeter poke holes outside of the hip. Smaller incisions yield less scarring, joint stiffness and infection. It also allows patients to get up sooner and move much faster — usually the first or second day after surgery. And there are few aesthetic issues.

Using the video as a guide, surgeons can repair a torn labrum and any associated issues in the hip.

Arthroscopy has been around for quite some time and is common for knee and shoulder issues. Hip arthroscopy can be challenging, but has been emerging in use.

When do you need hip arthroscopy?

Any surgery is usually recommended when other treatments such as rest, physical therapy or injections don’t work. If you don’t see results, you most likely will be referred to an orthopedic surgeon, who will perform the procedure to fix a torn or damaged labrum, articular cartilage or other soft tissues.

If you don’t remedy the issue, you are at risk of:

  • Arthritis
  • Dysplasia
  • Synovitis
  • Infection
  • Snapping hip syndrome
  • Femoroacetabular impingement (FAI)

Robert Trasolini, MD, is an orthopedic surgeon at Northwell Health Orthopaedic Institute. He is the assistant team physician for the New York Lizards Major League Lacrosse (MLL) team and has served in the same role for Harvard University athletics, the Boston Celtics, Merrimack women’s hockey, and the Boston Cannons (MLL).