Hip Arthroscopy

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Reports on SF Giants’ pitcher Tim Lincecum are showing an excellent prognosis after his recent hip arthroscopy surgery on his left hip. While he has a significant recovery time to return to his major league pitching, surgeons are suggesting he may be able to participate in spring training next year.

“The procedure, called hip arthroscopy, is an innovative procedure that provides certain patients who may be at risk for early hip arthritis with an option to potentially prevent hip replacement surgery,” says CPOSM’s orthopedic surgeon Keith Chan, MD, who specializes in this minimally invasive procedure. “For certain patients, particularly those who are very active, this can be an excellent option.”

To understand the procedure, it’s important to understand the basic anatomy of the hip. The hip joint is made up of two major parts—a socket and a ball. Cartilage that covers the ball allows for the smooth rotation and movement of the hip. The rim of the socket has a soft rubbery structure called the labrum which acts like a cushion and suction seal, like a rubber gasket. Some patients develop what’s called femoroacetabular impingement (FAI), in which the ball and the socket are no longer a perfect fit. For example, the ball can develop into a more oval-shaped structure, like an egg. When this happens, the non-spherical bone impinges on the edge of the socket, damaging the labrum and articular cartilage, causing pain. This can be seen among people who were very athletic as youths.(It is important to know that being physically active does not cause FAI).

To repair this impingement, surgeons like Dr. Chan use a small camera, called an arthroscope, inserted through a tiny incision in the groin. An image projected on a screen helps the surgeon guide tiny surgical instruments to the joint through additional incisions. There, he can clean up damaged cartilage, repair the torn labrum, and carefully shave the bone until the ball and socket fit smoothly together again. The entire procedure is done on an outpatient basis, meaning you can go home the very same day.

“Many patients return to their full and unrestricted activities,” says Dr. Chan. “For patients who are diagnosed before arthritis sets in, the outcome can be excellent.” While it may seem that Tim Lincecum’s estimated 20 weeks of recovery is long, patients have to understand he is trying to return to a demanding professional sports career. As a pitcher, in particular, he depends on repeated twisting of body. “However, you don’t have to be a professional athlete to qualify as a good candidate for this procedure. The key is to have the appropriate and early diagnosis with a trained expert.”

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