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Arthroscopic Surgery Can Resolve Pain, Say Researchers

Dec. 9, 2003 - Hip pain in a golfer may actually be caused by tears in the cartilage of the hip joint rather than arthritis, as it is commonly diagnosed, say researchers.

In such cases, prompt arthroscopic repair can resolve the pain and reduce the likelihood that the tears will lead to the development of arthritis and eventually require hip replacement surgery, principal investigator Derek R. Armfield, MD, tells WebMD. His research was presented at the 89th Scientific Assembly and Annual Meeting of the Radiological Society of North America.

The researchers looked at eight professional golfers who complained of hip pain. They found that all of the patients had cartilage tears as shown on both magnetic resonance imaging (MRI) and arthroscopic findings. Armfield is an assistant professor in the division of musculoskeletal radiology at the University of Pittsburgh Medical Center in Pittsburgh.

The implications extend far beyond professional golfers, he says.

"We have 25 million recreational golfers in the U.S.," he tells WebMD. He says when these people complain of hip pain, cartilage tears need to be considered as a possibility so that we can diagnose their pain accurately and treat it, so that they can return to their activities.

All patients in the study received a physical examination and an MRI, and afterward they underwent hip arthroscopy by the same surgeon. In all cases, the surgery was successful and they were able to return to professional golf.

Armfield cautions that, although the results were promising regarding the diagnosis and rehabilitation of cartilage tears, the study was small.

Cartilage tears can occur in recreational golfers as well as professional golfers, and we need to diagnose these patients' hip pain accurately, John F. Feller, MD, tells WebMD.

"The MRI can distinguish between hip tendonitis, more likely to occur in elderly patients, and [cartilage] tears, which may require arthroscopic repair in young patients. In any scenario, these patients are anxious to get back into active life, and we need to diagnose them accurately and treat them appropriately." Feller, who was not involved in the study, is the medical director of Desert Medical Imaging in Indian Wells, Calif., and a clinical assistant professor of radiology at Stanford, Calif.

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