Why Young Athletes are Getting "Hip" to Arthroscopy

No, it’s not your grandma’s hip problem... OR surgery. According to world renowned hip expert and orthopedic surgeon Dr. Dean K. Matsuda, 90% of his surgical cases are young patients who suffer from femoroacetabular impingement (FAI), a common condition causing nonarthritic hip pain especially in athletes. The injury is a result of repetitive abnormal collision of bone deformities, which can cause internal damage to the hip cartilage and labrum and may ultimately cause hip arthritis.

“Because FAI often occurs in young athletes, arthroscopy is a wonderful match. These patients want to get back in the game and expect minimally invasive surgery to be an option,” said Dr. Matsuda in an article he published for the American Academy of Orthopaedic Surgeons. “Hip arthroscopy, at one time viewed as a procedure in need of an indication, has evolved, in great part because of the unique technical challenges presented in the surgical management of FAI.”

The outcomes from arthroscopic surgery for FAI are as good or better than those from the open surgical approach and with less complications. Beyond pain relief and return to sports, Dr. Matsuda’s surgical goals include hip preservation with avoidance of joint replacement surgery.

To provide further support, Dr. Matsuda has released a list of five reasons young patients—especially athletes—should consider hip arthroscopy over classic open surgical hip dislocation. His list is the result of extensive research, case studies and personal experience. Dr. Matsuda, who directs the Hip Arthroscopy Center of Excellence at Marina del Rey-based DISC Sports & Spine Center, is chairman of the Sports Medicine and Arthroscopy program committee for the American Academy of Orthopaedic Surgeons, and his findings have been published in numerous trades and scholarly journals. Over the past 26 years, he has performed numerous sports medicine surgeries on various joints, but patient demand and professional interest have transformed his practice into one of the very few fully dedicated hip arthroscopy centers. He is also a former athlete who has been on both sides of the scalpel, having had the procedure on his own hips.

Dr. Matsuda believes that, compared with the classic open surgical hip dislocation procedure with greater trochanteric slide or flip osteotomy, the arthroscopic equivalent offers the following advantages:

1. True Outpatient Surgery – Hip arthroscopy can be performed as a true outpatient surgery with discharge home within two hours of surgery.
2. Minimal Blood Loss – Hip arthroscopies typically have blood loss of less than 20 cubic centimeters.
3. No Trochanteric Osteotomy-Related Complications –-In contrast to open surgery, an osteotomy (bone cut) is not needed to perform hip arthroscopy, thereby eliminating the risk of bone displacement, hardware failure or painful trochanteric bursitis.
4. Outstanding Cosmesis – This surgery can be performed with just two tiny incisions, which means very minimal scarring.
5. Quicker Rehabilitation – Patients may begin exercise bicycling 24 hours after surgery and can be running again in 12 weeks. The majority of patients report significant improvement in pain, mechanical symptoms and range of motion.

Before considering any surgery, Dr. Matsuda encourages patients and their parents to arm themselves with information and not hesitate to obtain a second opinion.