Clin Sports Med 25 (2006) xiii
CLINICS IN SPORTS MEDICINE FOREWORD
Hip Injuries
Mark D. Miller, MD Consulting Editor
O
rthopedic sports medicine used to be mostly the knee and shoulder. OK, throw in an occasional ankle or elbow to spice things up… but the hip? Interestingly, hip injuries have increased dramatically in recent years—or is it just that our recognition of them has increased dramatically? Hip arthroscopy, treatment of sports hernias, femoroacetabular impingement, hip instability, and a variety of other diagnoses and treatment options did not even exist 10 years ago! So, for those of you who don’t know what all the fuss is about—please read this issue carefully! Drs. Bharam and Philippon have done an excellent job of pulling this issue together and have covered the gamut of hip disorders in the athlete. Most of the topics are arthroscopically related—which is appropriate, because this a new frontier for most of us. This issue is thorough and comprehensive—please enjoy! Mark D. Miller, MD Professor, Division of Sports Medicine Department of Orthopaedic Surgery University of Virginia Health System P.O. Box 800159 Charlottesville, VA 22903-0753, USA E-mail address:
[email protected]
0278-5919/06/$ – see front matter doi:10.1016/j.csm.2006.01.004
© 2006 Elsevier Inc. All rights reserved. sportsmed.theclinics.com
Clin Sports Med 25 (2006) xv–xvi
CLINICS IN SPORTS MEDICINE PREFACE
Hip Injuries
Srino Bharam, MD, Marc J. Philippon, MD Guest Editors
T
he recent popularity of hip arthroscopy has led to a new focus on hip injuries in athletes for the sports medicine practitioner. Five to six percent of all adult athletic injuries and 24% of pediatric athletic injuries are hip-related injuries. Hip loading increases up to 5%–8% during athletic activity and may place the athlete at risk of injury during athletic participation. Hip pain in the recreational to elite athlete in both men and women can result from either acute injury or repetitive hip-demanding activity, affecting athletic participation. These sports-specific injuries are seen in multiple sports, including cutting activities (football, soccer), repetitive rotational activities (golfers, martial artists), dancers, and skaters. Evaluation of hip pain in the athlete can be challenging to the sports medicine practitioner. This requires a detailed history and hip exam and appropriate imaging studies. Communication with trainers and physical therapists is also essential in the evaluation process. Recent advancements in hip arthroscopy have expanded our knowledge of the management of athletes with hip injury. Adaptations to arthroscopic instrumentation have been established to overcome the constrained hip joint and dense muscular envelope. Flexible instrumentation has also been developed for improving access to the hip joint in both the central and peripheral compartments. Refined arthroscopic techniques have improved our ability to manage labral tears, chondral injuries, capsular laxity, impingement, loose bodies, ligamentum teres tears, and snapping hip syndrome. Structural abnormalities predisposing athletes to intra-articular hip injury can also be addressed with arthroscopic intervention.
0278-5919/06/$ – see front matter doi:10.1016/j.csm.2006.01.005
© 2006 Elsevier Inc. All rights reserved. sportsmed.theclinics.com
xvi
PREFACE
Managing athletic hip injuries with hip arthroscopy and a well-defined rehabilitation protocol can safely return athletes back to competition. We would like to thank our authors for their dedication in providing us their expertise and update on this subspecialty field of sports medicine. Srino