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 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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Excellent research effort here. I have long believed that we have not heard the last of A-Rod’s hip. Also very skeptical that that A-Rod will be a plus in latter contract years. Yanks are on the hook for the money, which is bad enough. But at some point he may really not be worth the roster spot. At some point Yanks will have to at least confront question of eating salary and cutting him. Hopefully, this won’t be issue in the next three or four years.
Your link demanded a password, so I read the abstract on PubMed. (I’m a medical editor in real life.) Your summary seems to be accurate, with one clarification: when the articles says “level of play” they mean the same team or league; they don’t mean that the athlete was still as good as he was before, which makes it slightly less hopeful for Rodriguez. The Yankees won’t be happy if he settles in as a below-average major leaguer.
Whoops, sorry about that, I fixed the link. And yes, I should have clarified that “same level” did not necessarily refer to performance, but rather, to the actual league/level of competition.
I always enjoy well-researched articles on almost any topic and this one was both well-done and an interesting read; more so even than the Times article that prompted it; thank you for your efforts here, Eric.
I’m not a medical expert in any way, but know something of the mainstream media and how it reports research. Boiled down, the Times article simply states that since the surgery is relatively new, there is no long-term studies to verify if it leads to arthritis or prevents it. For that matter, one could also write a scientifically annotated, expert-citated article that there’s no proof it does or doesn’t contribute to facial acne and venereal warts.
It’s simply a non-news feature story that seeks to explain to the lay reader the nuts and bolts of a procedure that has appeared more and more in the news pages of late in connection with popular athletes, and infers that this development has led to it becoming common among young athletes and the general populace as well. That’s fine. But the arthritis “angle” is meaningless. Nobody undergoes the procedure to avoid arthritis, they do so to relieve chronic, lingering continual pain. And a casual Google News archive search finds dozens of athletes of nearly every sport, age and size who extol the instant, complete and permanent relief it provides.
That may not be news, but you don’t have to be an expert to understand how that bodes well for the future performance and future joint health of anyone who undergoes it — teenage athletes and Alex included.
The clock ran out on me before I could make a typographical correction in my comment above. The sixth line should read: “…there ARE no long-term studies…”
A thousand pardons.
Thanks. If I had more time (and my internet was being a little more reliable at the time) I would’ve tried to go into a little more depth with the research. I decided to write on the topic after seeing the article, but before I actually looked at the studies, so I had no idea what I would find.
Eric,
My thought is this: Who really knows what the future entails for A-Rod? Did the surgery do the job it was supposed to? Yes-it stopped the pain. Moreover I believe it did the job better than expected as Alex didn’t have to go through another surgery like originally predicted.
Alex is still a top-15, maybe a top-10 player. He needs a couple of injury free years and he will show us the 35 homer years he’s still capable of. According to Joe Torry, Alex works harder than any other player he’s ever seen. While this may be true, maybe his work ethic has done more harm than good.
But back to your article, we don’t know what this surgery will mean to Alex in 10 years. As long as it has prevented pain now, that’s all we (as fans) care about. If arthritis develops, we (as human beings) should care, but most likely we won’t. The guy has plenty of money and will get the best care possible.
As long as the A-Hip holds up through 2017, Yankee fans will rejoice. And if the rest of the A-Body stays healthy, you might see a new homerun king.
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