A-Rod Needs Hip Surgery - What's Wrong and How Will They Fix It?

Ok I'll admit it.  I am a big sports fan. I'm also a physical therapist. Whenever someone gets injured and they put a little blurb on the bottom of the screen saying "Bob Smith will undergo knee arthroscopy and will miss the next eight weeks," I always want more information.

For instance, arthroscopy doesn't really tell you anything. Arthroscopy is an approach to surgery that uses cameras and small tools that allows surgery to be less invasive, only requiring a few small incisions. But that doesn't tell you what the surgeon is going to do - is she going to remove the meniscus, repair cartilage, or reconstruct a ligament.

They all can be done arthroscopically but the ramifications and time away from the game are all very different.  With this in mind I thought I would go into what most likely is going on with A-Rod, since this is breaking news. 

One point I do have to make is that I have no more information than you guys with regards to what's going on. However I can make some pretty accurate (I hope) educated guesses based on the information we have heard.

What I have heard is that A-Rod is having a procedure done on his hip to remove/repair the labrum, remove a cyst and shave down his hip bone.  He will be out 4-6 months as a result.

These findings are somewhat of a classic case of what is called hip impingement syndrome.  There are two types.  One is called Pincer syndrome and the other is called CAM impingement - and of course you can have a combination of the two.  The mention of having to shave down the bone leads me to believe that he has CAM impingement.

Cam impingement is when the head and/or neck of the femur is too large for the socket of the hip.  Usually the bone doesn't taper down enough so that it impacts (impinges) the hip socket, right where the labrum is located, when the athlete tries to flex his hip.  This repeated impingement causes a tear of the labrum as well as the formation of a cyst. (check out the photo that says CAM - look at the shaded portion of the bone, which is the part that doesn't taper enough as compared to the picture of the normal hip)

The surgeon is going to repair or remove the torn piece of labrum, remove the cyst that formed, and shave down the part of the bone that isn't tapered enough so that A-Rod can flex his hip without impinging himself.

The  reason it takes so long for the recovery is because the labrum has to heal and the bone has to heal.  Often times they have to take the hip out of the socket to perform the procedure so instead of cutting through the muscles of the hip to get to the joint (which would seriously jeopardize any athletic career) they actually cut a piece of the bone off that the muscles attach to and then use a pin to reconnect the bone rather than tear up the muscles.  This all needs significant time to heal, often mandating that the patient not bear any weight on that leg for a while.  These factors all make the rehabilitation longer.

Once again I want to clarify that this is my best guess but I am pretty confidant that I'm on the mark (with at least some of this). I hope this gives you a little more information about the type of procedure that A-Rod is most likely going to go through.  And I do not believe this has anything to do with performance enhancing drugs.  Most likely A-Rod was born with two hips that weren't normal (remember he had the other one done in a similar fashion a few years ago).

Questions and comments always welcome

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Yours in Health,

Chris Ostling PT, DPT