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Minimally Invasive Surgery Offers Help for Athletes


19 February 2008

Sports medicine has made great strides in treating joint problems that once sidelined athletes.  Mike O'Sullivan reports, a new procedure for treating a sport-related hip disorder is getting athletes back on track with little recovery time.

Doctor Philippon and Doctor Dean Matsuda (right)
Dr. Mark Philippon (left) and Dr. Dean Matsuda (right)
Dr. Dean Matsuda was an athlete in high school, and suffered from the common injuries that people face in sports - bumps, bruises, pulled muscles, and sometimes joint problems.  He became an orthopedic surgeon, and now helps other athletes with their problems.

"Although I have treated collegiate athletes and football players, the average patient that comes to me in my practice is the weekend athlete like myself, and they've grown up doing all sorts of sports, including contact sports like football," he said.

Dr. Matsuda practices at the Kaiser Permanente medical group in Los Angeles, where surgeons perform common procedures on the knee and shoulder.  He is one of a small number of surgeons trained in a technique to correct a problem called hip impingement through arthroscopic surgery, using a camera and instruments inserted through small tubes.  He says the procedure is not difficult for knee or shoulder problems, but is challenging with the hip.

"It's deep within the body," he explained.  "There are major nerves and vessels adjacent to it that can get damaged.  There is a ball and socket configuration which is inherently round, yet we're putting in straight instruments that have to travel deep through the body into that compartment."

Doctor Dean Matsuda treating hip impingement with arthroscopic surgery
Dr. Dean Matsuda performing arthroscopic hip impingement surgery
He says surgeons apply traction to pull the joint open so they can work through tiny incisions.  Cartilage is trimmed and bony growth that impedes the joint's movement is removed.  Recovery is usually quick - patients are back on an exercise bike in 24 hours and playing sports again in a few months.

Dr. Matsuda is still an active athlete, and has had the new hip surgery himself.  He says the procedure treats a problem that once benched an athlete, or required an operation with a large incision and longer recovery time.  He says that not all doctors know the options, and he faces the challenge of getting the message out to his fellow physicians.

"I had a patient just yesterday, an 18-year-old high school [student], active young man, hip problems," he said.  "I talked with him and his mother.  He told me that the previous orthopedic surgeon that he saw him just to give up sports and play video games.  Obviously that would not be an acceptable response to me if I was him, and it certainly wasn't to him or his mother either."

The arthroscopic hip impingement surgery that Dr. Matsuda performs is only available in a handful of places in the United States and in countries including Brazil, Britain and Australia.

Hip surgery seen through the arthroscopic camera
Hip surgery seen through the arthroscopic camera
Mark Philippon, a leading orthopedic surgeon in Vail, Colorado, says it offers hope to injured athletes who faced physical limitations or a bigger operation in the past.

"I think now we have the diagnostic ability," he said.  "We have the surgical procedure and the rehab to allow these patients to get better and return to a dynamic and active lifestyle."

Dr. Matsuda says amateur athletes should do their best to avoid repetitive injuries, but if they develop joint problems, they should look for a medical specialist trained in the latest surgical techniques.

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