If you live in Chicago as do I and you follow the Bears as I have since the days of Dick Butkus and more recently Mike Ditka, you can’t miss the hourly commentary in the media and press concerning Brandon Marshall’s absence from the practice and playing field this week because of his “slow rehabilitation” following arthroscopic hip surgery after last season. It was his third since 2009 according to reports. I have never evaluated Marshall as a patient but I have been involved in the care of many professional football players over my surgical career so I feel comfortable writing this Blog.

No matter what sport, where there is contact, there is the potential for injury. Even without contact, some of the extreme positions demanded by many sports place the hip at risk for dislocation, fracture, labral tears and cartilage injury. The long term risk following hip injury is early onset degenerative arthritis or avascular necrosis (loss of blood supply). The disturbance of blood supply may additionally be secondary to the injury or the adverse outcome of arthroscopic surgery.

How might stem cells make a difference in a hip injury? There is increasing scientific evidence that stem cell intervention using Bone Marrow Aspirate Concentrate may influence healing of a labral tear and articular cartilage geometric injury. The evidence in the laboratory points to cartilage healing with stem cells and the preliminary evidence in clinical trials now underway support that theory in practice. There is as well an increasing body of anecdote that patients with symptomatic HIP labral tears documented on MRI may be rendered asymptomatic via stem cell intervention followed by MRI documentation of labral injury healing after which return to the playing field may be successful.

Then there is the recent epidemic in the diagnosis of Femoral Acetabular Impingement (FAI) to which pain in the hip of young adults is increasingly attributed. One cause of FAI is a torn acetabular labrum and the diagnosis on the MRI is all too frequently followed by arthroscopic intervention. What we don’t have though is outcomes data to support the arthroscopic or worse yet, open hip interventions in the aforementioned hip condition.

“When in doubt, whack it out” should not be an indication for hip care or any other surgery for that matter. As I stated at the outset, I don’t know anything about the particulars of Brandon Marshall’s hip problem but before you sign that surgical consent, consider stem cell intervention to avoid or postpone surgery of any orthopedic condition.

 

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