Andy Murray serves up ace way to end agony of NHS hip-pain patients
By Carol Davis and Eve Simmons
THE operation that rebuilt tennis ace Andy Murray’s hip could become a new ‘gold standard’ NHS operation for British joint pain patients, thanks to results of a landmark trial. Experts hope the data will persuade health chiefs to stop using surgery only as a last resort, and instead offer it early in a bid to restore quality of life to thousands of sufferers.
The major British study involving 348 patients carried out across 23 hospitals compared the impact on hip patients of physiotherapy alone with surgery followed by physiotherapy.
After a year, although both groups improved, those who went under the knife were significantly more mobile and suffering less pain. The findings could offer a lifeline for 30 per cent of the UK population who are estimated to have abnormally shaped hip joints, otherwise known as fe moro ace tabular impingement (FAI) – the same condition that affected Murray.
He had surgery in January and is hoping to return to full tournament fitness.
The condition – which raises the risk of developing arthritis – often goes undiagnosed and is more commonly detected in t hose who are physically active. This is because the condition worsens when pressure a nd strain is put on the hip socket, causing agonising pain during exercise. It is the most common cause of groin and hip pain in performance athletes. The hip joint is a ball and socket joint: the ball of the top of the thigh bone (femur) fits into a socket lined with cartilage to keep it in place and allow smooth movement.
Femoroacetabular impingement happens when either the ball of the hip joint is more egg shaped than round, or the edges of the socket protrude, or both.
This hinders smooth movement of the joint and causes damage to the delicate cartilage.
Damian Griffin, professor of trauma and orthopaedic surgery at Warwick University, says the syndrome is especially debilitating for young, active and otherwise very healthy individuals. ‘It can force them to give up sport and hobbies, to struggle physically at work and even to resign from jobs that require a significant amount of physical activity.’
Often, patients are misdiagnosed with groin strain and treated with a course of physiotherapy – exercises designed to strengthen muscles and heal scar tissue – and high-strength pain killers.
‘Surgery is often seen as a last resort so patients often struggle on for years, by which time damage can be so severe that a hip replacement is the only option, but our results show that hip resurfacing has a fast recovery time and is highly effective, so should be considered early on,’ added Griffin, who led the new study.
The operation takes about 40 minutes and is performed under general anaesthetic. First two or three incisions, less than an inch long, are made over the hip joint. An arthroscope, or camera on a rigid tube, and the instruments are inserted through the incisions.
A burr, a ball- shaped cutting device, is used to reshape the joint so it moves smoothly. During this time, any damage found in the cartilage can also be fixed.
Professional f ootballer Matt Butcher, 21, midfielder for AFC Bournemouth, noticed a pinching pain in his right hip while doing deep squats or hip flexion in March, and a deep clicking in his hip.
Professor Griffin diagnosed FAI, and said it would worsen within two to three years. ‘It was a shock,’ says Matt, ‘since I’d known older players with hip injuries who struggled to come back.’
He had hip arthroscopy to reshape the hip and repair cartilage in April. ‘The pain and clicking have gone, and I hope to go on playing at the highest level as long as I can.’ For more information visit hiparthroscopyclinic.co.uk