• Lady Gaga's hip surgery illustrates advances

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  • Lady Gaga had hip surgery last week at age 26. She had hip pain that worsened severely after a concert about two weeks ago. MRI showed a tear of the cartilage, called labrum, deep in her hip joint. Lady Gaga had an operation by a surgeon who used small telescopes and cameras for the repair. Not long ago this injury may have ended her dancing, severely crippling her career.
    Hip labrum tears, what do you know? T or F?
    1. They usually heal on their own within 3-6 months.
    2. They are as common as shoulder labrum tears.
    3. Royal’s Alex Gordon had hip labral tear.
    The hip is a very stable, deep ball and socket joint. The shoulder, also a ball and socket joint, is shallow and therefore, very unstable. That is why we as humans tend to dislocate our shoulders, but rarely our hips. The labrum is cartilage that lines the rim of the socket sealing the joint like a gasket and providing stability.
    Labral tears in the shoulders of major league pitchers are common because of overhead throwing. In the hip, the labrum is vulnerable to injury because it bears a lot of weight. Repetitive stress, such as with dancing, can fray and tear the labrum which will not heal by itself because of a very poor blood supply. Therefore, tears must be stitched and frayed areas smoothed for recovery.
    In times past, a hip labral tear would be repaired using a very large incision to open the joint. The prospects for full recovery were limited. Lady Gaga is the beneficiary of enormous advancements in hip surgery where orthopedic surgeons insert small telescopes into the joint for repair. The procedure is called arthroscopy and the surgeons, arthroscopists. Arthroscopy decreases post-operative pain and preserves muscle and joint function. It also allows for the precise repair of the labrum without affecting the other structures of the deep hip joint. Amazing. Twenty years ago there were no hip arthroscopists. Anywhere. Today in Kansas City there are a handful.
    Deep hip injuries are not unusual in professional dancers and other high-risk athletes such as skaters, gymnasts and runners. What surprises many is the young age at which these injuries are diagnosed. But, often, through many years of training, these are young bodies on old joints. The Royals’ Alex Gordon and Yankee’s Alex Rodriguez had surgeries similar to Gaga’s when they were 25 and 34 years old respectively. MRI has advanced our ability to detect these problems early. Arthroscopy has advanced our ability to fix these hips and return that young performer back to the stage or field.
    Lady Gaga will face months of rehabilitation, but her young age and good physical conditioning from dancing will aid her recovery. She is at greater risk for hip osteoarthritis than other 26 year olds who never had a labrum injury or surgery. But she should make a full recovery and rejoin her "little monsters" on tour in about 6 to 8 months.
    Page 2 of 2 - Lady Gaga has named her wheelchair Emma, to the delight of her ever-watchful "little monsters." When she does reclaim her place on the stage, I am sure it will be the most sensational return from a hip surgery in medical history. Emma may even make an appearance.
    To learn more about hip arthroscopy contact the American Academy of Orthopedic Surgeons at orthoinfo.aaos.org
    Answers: 1. T; 2. F; 3. T.

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