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Lessons in the Elite Athlete: How I've Evolved My Hip Practice J. W . W. . Thomas By Byrd, MD MD Hip Pr Preser ervati tion f for L Life Orthop thopae aedic S c Summit 2 t 2017 17 - Evolving ng T Techni hniques ues Las Las

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Lessons in the Elite Athlete:

How I've Evolved My Hip Practice

J. W

. W. . Thomas By Byrd, MD MD

Hip Pr Preser ervati tion f for L Life

Orthop thopae aedic S c Summit 2 t 2017 17 - Evolving ng T Techni hniques ues Las Las Vegas as, N Nevad ada Decem ecember er 8th

th, 201

2017

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“He w

e who d desi sires s to prac actice ce sur urgery mus must go

war”

– Hippocr crates tes

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“No bette

tter c clin linic ical la l laboratory than the f fie ield lds of athle letic ic c competitio ition”

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Arthroscopy: The Journal of Arthroscopic and Related Surgery 10(3), 1994:275-280

Hip Arthroscopy Utilizing the Supine Position

J. W. Thomas Byrd, MD

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"Hip p arthros throscop

py i

is a triumph ph

f
f te

technique ov

ver rea

r reason... The There i is no no pl place for for it. t."

1997
2002

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NFL Physicians Society Sports Science Symposium, 1999

Persistent Hip Pain in an Offensive Lineman

J. W. Thomas Byrd, MD

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Clinics in Sports Medicine 20(4), 2001: 749-762

Hip Arthroscopy in Athletes

J. W. Thomas Byrd, MD, Kay S. Jones, MSN, RN

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Clinics in Sports Medicine 20(4), 2001: 749-762

Hip Arthroscopy in Athletes

J. W. Thomas Byrd, MD, Kay S. Jones, MSN, RN
Me

Mean im improvement 3 t 35 p poin ints ts

93% dem emonstrated > > 10 10 p pt t improveme ment nt

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Results ts

20 40 60 80 100 1 3 6 12 24 60

Score re Months nths

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Am J Sports Med, 2009; 37(11): 2140-2143.

Hip Arthroscopy in Athletes: 10-Year Follow-up

J. W. Thomas Byrd, M.D.

Kay S. Jones, M.S.N., R.N.

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Am J Sports Med, 2010; 37(11): 2140-2143.

Hip Arthroscopy in Athletes: 10-Year Follow-up

J. W. Thomas Byrd, M.D.

Kay S. Jones, M.S.N., R.N.

Median

an i improvement 45p 5pts

87% r ret eturn to to sp sport

33% co converted t to THA a at ave. 6 6 yr yrs

– Du Durabi bility o

f results u

uncer ertain

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Clinical Orthopaedics and Related Research 417, 2003:112-120

Femoroacetabular Impingement: A Cause for Osteoarthritis of the Hip

Ganz R, Parvizi J, Beck M, Leunig M, Notzli H, Siebenrock KA

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Am J Sports Med, 2011 Jul; 39 Suppl; 7S-13S

Arthroscopic Management of FAI in Athletes

J. W. Thomas Byrd, MD

Kay S. Jones, MSN, RN

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200 A

Athle letes w wit ith F FAI

– Median an improvem vement 24pts s (preop 72

p 72; posto top 9 p 96)

6pts ts: B Bipo polar c chondr dral d damage age

– 49 Mic Microfx’s ’s: Me Median improve vemen ent 2 26p 6pts s

FAI Athletes etes

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200 A

Athle letes w wit ith F FAI

– 181 ( 1 (90%

0%) Retur

urne ned t to s sport

5% p profe fessional

5% co collegi giate

FAI Athletes etes

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200 A

Athle letes w wit ith F FAI

– Complic licatio tions:

5 tr

transient n t neuropr praxias ( (all r

reso solve ved unev eventf entful ully)

1 mild

ild HO HO (no tx

no tx; no ef no effect on out

n outcome)

– On One ( (0.5%

5%) c

conver verted t to THA – Four Four ( (2%) r repeat at a arthrosco scopy y

FAI Athletes etes

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Unique considerations of treating Elite Athletes

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Ex Exceptions tha that I make i in n how how I tr treat El Elite te A Athl thletes

–Be careful w when ma making g except ptions t to norma rmal l standa dards ds o

f care!

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Excep

epti tions

ns are

re re reali lity

Much m

uch mor

re ti

e time/ e/resou

urces to

to dedica icate t te to recov

very

ery

Highly

hly m motivated ated

– Can ma n make y you

u look
ok good
od
By d

defini inition, tion, h have h e high p pain in toleran rance ce

– Good & d & Ba Bad

Exce cepti tions?

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Exce cepti tions?

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“R “Reme membe ber, y you d don’t p pla lay foot

otball f

for

your

ur heal

health th”

Exce cepti tions? Crai raig D. Bri righam, MD MD

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Athlet

letes es have f fin init ite lif life o

compe mpetitive a athle letic c care reer

– Qu Quic ickly ly c clo losin ing w win indow of opportu tunity ty to gener erat ate subst stantial al i income – May c choo hoose to

be s

shor hort s sighted f for

econ

ic r reasons

ns
But i

t it t must t be informed d d dec ecision o

n th

their part

– May a y apply t y to professi ssional al / / elite e / schola

larshi

hip / possib ibly h high s school

athletes es

Exce cepti tions?

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By the t time athl hlete te lands nds on m

n my door

doorstep, unlik likely ly t the h hip ip will ill ever be be r returned d to to norm normal

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Can d

do ma many t thin ings gs t to dimin iminish sympto toms & & perhap haps i improv

e long

ngevity of
f joi
int

nt, b but can ut can nev never tru ruly re restore n nativ ive v vir irgin gin h hip ip

My My doorste tep

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Earlier r

ier recogniti nition o

n of patho

holog logy ma may b be helpf lpful

– Perhap aps e ear arlier er i inter erve vention m may lead ad to improve ved r resu sults

Earli

rlier re recogn gnitio ion o

f hip

ips “a “at ris risk” is is crit ritical

– Mo Modific icatio tion o

f train

inin ing programs and c counse seling m may l y lead ad t to bet etter er prevent ntion

My My doorste tep

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Our s surgical s ical solutions tions a are imper erfect ect

– Future is is in in Or Orthobio iolo logics

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