Hip Procedure Can Extend Athletes' Careers

Newsday—August 8, 2009

Carlos Delgado felt the pain in his right side and figured he'd pulled something - a groin, most likely. Maybe a strained hip flexor. Something nagging, but not needing surgery.

Turns out, Delgado didn't know what he was dealing with. Luckily for him and a growing list of pro athletes, there were doctors who did know. And Delgado, expected to return to the sagging Mets this month, may have a new lease on his career thanks to the diagnosis of a torn hip labrum and the wonderful new world of arthroscopic hip surgery.

"Everybody I've talked to will tell me that if I had the injury 10 years ago, they say, 'You can't play no more, come back in 20 years and you'll get a hip replacement,' " Delgado said. "I guess it's getting diagnosed more accurately these days. I'm surprised. You figure in the year 2009, with all the technology and they operate on everything, but they didn't have a great scope surgery for your hip until 6-7 years ago."

A pioneer in this delicate surgery, Dr. Bryan Kelly practices at Hospital for Special Surgery in New York.

"The hip is a little bit different than other joints in that it's a highly structured joint," said Kelly, who went from a fellowship studying with Philippon six years ago to now performing 350 of these surgeries a year in New York. "It's supposed to be a perfect ball-bearing joint. When there are changes in the morphology of the hip, the labrum is the first thing that gets damaged."

Bony growths inside the hip socket can chafe at the labrum, the cartilage that surrounds the socket, causing a tear. Kelly and Philippon repair the torn labrum and shave down the growths to re-establish the smooth articulation of the joint. That's the good news once a player gets the diagnosis of a torn labrum - femoroacetabular impingement, in medical terms.

But simply getting to that point, even with so many high-profile names getting their hips done, hasn't been easy. "It's not a new injury," Kelly said, "there's simply a lot of confusion about it."

Kelly cited a recent study that found the average time for a patient to receive an accurate diagnosis of a torn labrum was 21 months; the number of experts seen by a patient in the study averaged 3.3. For a pro athlete, that's enough time to disappear from a roster.

Team trainers are taught to look for deeper causes of soft-tissue injuries such as strained groins and hip flexors and even sports hernias, which is a relatively new diagnosis. But looking for underlying hip issues had never been the thing to do until recently.

The surgery simply wasn't there a decade ago. "It's like going back 30 years ago and nobody's had a 'Tommy John,' " Delgado said of the elbow surgery that saved the former All-Star pitcher's career. "Now, everybody's had a 'Tommy John.' And they save their career."

Read the full story at newsday.com.