I was looking for something other than hot stove rumors and player breakdowns to write about, when I came across an article by Gina Kolata in yesterday’s New York Times questioning the effectiveness of the hip surgery that Alex Rodriguez underwent two years ago. It wasn’t looking specifically at the Rodriguez case, but rather, the evidence supporting the surgery overall. I know this isn’t typical TYA fare, but I was curious to see what the evidence had to say about A-Rod’s surgery, and how it may predict his ability to hold up over the remaining duration of his albatross contract.
Just to recap Rodriguez’s situation, he was having pain due to a torn labrum in his hip, which was being caused by his hip joint not fitting well into the socket of the hip (the medical term is femeroacetabular impingement, for those of you who are taking notes). The impingement exacerbated the strain on the hip caused by a number of baseball activities (especially the swing), leading to the labrum tear. Rodriguez had the labrum and impingement repaired by renowned orthopedic surgeon Marc Phillipon, whom the article credits with being one of the first surgeons to do the impingement surgery.
There are two outcomes that would matter for the surgery: the short-term reduction of pain, and the long-term prevention of arthritis. The Times article cited a Greek study on patients who did not have pre-existing pain (but did have hip impingement), which found that impingement was not likely contributing to an increased rate of arthritis. I was curious about what other studies out there have found. To satisfy my curiosity, I fired up Pubmed and searched for recent studies looking at “femoroacetabular impingement” in athletes. The studies were probably a bit over my head, but I wanted to see what the range of potential long-term outcomes could be for A-Rod.
The most recent study I found, which was a case series that included 47 “high level athletes”, found that the impingement surgery improved hip function in the short term, allowing 73 percent of them to return to the same level of play (the study population was a mix of high school, college, and professional athletes). It should be mentioned that the study population had an average age of about 23, which would make them significantly younger than A-Rod when he had the surgery. Most of the other studies reported similar results, looking primarily at short-term outcomes of being able to resume playing sports at the same level.
Unfortunately, I wasn’t able to find much about long-term outcomes, which is not surprising since arthritis, as a chronic degenerative disease, can take years or even decades to develop. Unlike the people in the Greek study, Rodriguez was having pain in his hip, and as a professional athlete probably subjects his hip to higher strain than the average person. Based on the limited findings in the literature, it seems that despite the lack evidence about the long-term likelihood of developing arthritis, Alex Rodriguez’s surgery was likely beneficial in the short-term.
However, there’s still significant uncertainty remaining about the possibility of developing arthritis, which would likely cut short A-Rod’s career if it developed young. We hope that the surgery did in fact help prevent further damage to A-Rod’s hip, and will help him hold up over the long haul. Considering the years and dollars remaining on Rodriguez’s contract, ensuring that he stays healthy is pretty much the only way that the Yankees will make the investment somewhat worth it.
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