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SPORTS MEDICINE:
Hip Procedure Grows Popular Despite Doubt
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Hip Procedure Grows Popular Despite Doubt
By GINA KOLATA
Published: November 15, 2011
New York Times
http://www.nytimes.com/2011/11/16/health/
hip-impingement-grows-popular-but-remains-unproven.html
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A shorter URL for the above link:
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http://tinyurl.com/7xxrsr7
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It is one of the most popular operations in sports medicine. It comes in
various forms, all with the same name: Hip impingement or bone shaving
surgery. World-renowned athletes have had the operation the Yankees third
baseman Alex Rodriguez had it about two years ago and the sprinter Tyson
Gay had it last summer.
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But some sports medicine researchers are asking: where is the evidence
that shaving bone helps? Might the bumps or irregular shapes they call
impingement be just normal variations? Does the shaved bone grow back?
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And it is not just professional athletes who are having the operation. Now
some surgeons are even operating on teenage athletes with hip pain.
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The idea is that bone that has rough edges or an irregular shape in the
hip is rubbing against soft tissue in the joint, causing tendons to fray
or muscles to tear. The hope is that by shaving and smoothing the bone,
surgeons can protect patients from further injury and also protect them
from developing arthritis. The amount of bone removed varies but can be
significant sometimes, as much as a third of the thigh bones top.
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One difficulty in assessing the operations effects is that it is combined
with other procedures to repair torn tissue. When patients say they feel
better, is that because their impingement was fixed or because their torn
tissue was repaired, or both? Another is that it takes years for arthritis
to develop so it will take years for studies to determine if it has been
prevented.
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The combination surgery also complicates efforts to estimate the cost of
the operations because it is billed under a variety of codes. The cost is
also hard to evaluate because medical centers say that their charges are
proprietary information. But at one academic medical center, the
orthopedists charge for hip impingement surgery is about $4,400. The
doctors charge to repair torn cartilage is an additional $4,400. Hospital
charges are extra, as are charges for the months-long rehabilitation, but
insurers almost always pay less than what is charged for the operation.
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Yet despite the popularity of hip impingement surgery, said Dr. Harry E.
Rubash of Harvard Medical School, no one has really proven that it is
uniformly helpful to the patient.
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The complete article may be read at the URL above.
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