Arthroscopy Results Equal to Open Surgery for Common Hip Problem

Healthymagination.com—October 12, 2011

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.

Femoroacetabular impingement, or FAI, develops when there is a mechanical mismatch between the ball and socket sections of the hip joint. 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 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.”

Kelly and another surgeon at 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.

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 Dr. Ira 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.

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.