Hip arthroscopy for labral tear in an athletic young female

December 5, 2003, ST. LOUIS * Holly Warrick never imagined she needed hip surgery.  Like many, when she thought about hip surgery, she envisioned people a lot older than her.

As a senior at Marquette High School in suburban St. Louis, Holly led a very active life, despite an arthritis diagnosis during her freshman year.

“All through high school I ran cross country, played soccer and danced ballet, jazz and tap through the night,” says Warrick, “But then I started having hip problems during my junior year of cross country.  I noticed I was getting slower and I was pushing myself just as hard.”

That’s when things got worse, “By Christmas-time I couldn’t get into my car,” she recalls.

That’s when she was referred to John Clohisy, MD, Washington University orthopaedic surgeon at Barnes-Jewish Hospital.  He diagnosed a hip joint cartilage tear and recommended hip arthroscopy during the Spring of 2002.

“I had hip pain since freshman year and had medication for that, but I was really surprised I needed surgery,” says Warrick.

Many are.  That’s why Dr. Clohisy developed the “Young Adult Hip Program” at Barnes-Jewish Hospital and Washington University School of Medicine.

“Very frequently, these patients have a deformity or hip joint problem that is not easily recognized,” says Dr. Clohisy, “Patients don’t get a definite diagnosis and may go many years without treatment.”

Young adult hip disorders include congenital, developmental, posttraumatic, pre-arthritic and early arthritic problems.  Patients with these disorders frequently present at 15 to 50 years of age and often complain of activity-related hip pain.  Many of these patients had childhood hip disease and have a residual deformity that continues to be problematic.  If caught early, many of these problems can be corrected and the hip joint preserved so patients are less likely to need hip replacement at a relatively young age.

If untreated or undiagnosed, however, patients may develop early arthritis, “And as it progresses it ultimately could lead to end stage arthritis at a very early age,” says Dr. Clohisy.

Over the past several years, the diagnosis and treatment of young adult hip problems has rapidly evolved.  Improved understanding of subtle hip deformities and intraarticular hip pathologies has led to the development of surgical procedures that better address these diseases.  There are three major types of surgery that are utilized to treat young adult hip problems.

Hip Arthroscopy * A minimally invasive procedure enabling surgeons to inspect the hip joint and take care of problems within the joint without a major open hip surgery.

Hip Joint Debridement * A trimming of the bones around the hip joint done through open procedures to correct subtle abnormalities of the hip and relieve bony impingement around the joint.

Hip Osteotomy * A cutting and repositioning of the acetabulum (hip socket) and/or the femur (hip ball) to correct significant deformities of the joint.

Because these patients require specialized diagnostic and therapeutic modalities, Dr. Clohisy developed a comprehensive program for patient evaluation and treatment.

Warrick has done remarkably well following her procedure.  Currently a student at the University of Missouri in Columbia, she feels great.

“After surgery I spent the whole summer rehabilitating,” says Warrick, “I had always been active and I knew I couldn’t do any more competitive running, but I’ve taken up walking and I take kickboxing and spinning.”

“My hip is totally fine,” she says, “It feels really good.”

For more questions about the “Young Adult Hip Program” at Barnes-Jewish Hospital, call Dr. Clohisy at 314-747-2566 or 314-454-5925.