Author Topic: Report: IT hip injury more than just torn labrum; arthritis + loss of cartilage  (Read 3255 times)

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Offline Roy H.

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Didn't find one study of non-surgical outcome (e.g., rehab, rest).

This is the oddest thing about the situation to me. Why rest when it seems normal to have surgery? Or do those studies only look at guys who ultimately decided on surgery? Do they ignore other players who've had a tear and then recovered without surgery?

We are all flying blind here. But that seems like an answerable question.

Rest is a pretty common recommendation. Anthony Davis, for instance, has played through a torn shoulder labrum for three years.


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Offline Boris Badenov

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Didn't find one study of non-surgical outcome (e.g., rehab, rest).

This is the oddest thing about the situation to me. Why rest when it seems normal to have surgery? Or do those studies only look at guys who ultimately decided on surgery? Do they ignore other players who've had a tear and then recovered without surgery?

We are all flying blind here. But that seems like an answerable question.

Rest is a pretty common recommendation. Anthony Davis, for instance, has played through a torn shoulder labrum for three years.

I saw that. But hip?

Offline Roy H.

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Didn't find one study of non-surgical outcome (e.g., rehab, rest).

This is the oddest thing about the situation to me. Why rest when it seems normal to have surgery? Or do those studies only look at guys who ultimately decided on surgery? Do they ignore other players who've had a tear and then recovered without surgery?

We are all flying blind here. But that seems like an answerable question.

Rest is a pretty common recommendation. Anthony Davis, for instance, has played through a torn shoulder labrum for three years.

I saw that. But hip?

No idea. The ESPN article quoted the surgeon who noted that many athletes opt not to have surgery and you never hear about them due to confidentiality laws:

Quote
Players have put off surgery before and found success, but real-life examples are hard to come by because of confidentiality agreements with doctors and patients. Philippon says "a lot of players" come to see him for a hip tear but they don't fix it surgically, and no one hears about it.

From a layman's perspective, surgery makes sense:

Quote
Fortunately, these labral/impingement surgeries are thought to have good success rates in high-level athletes. A 2011 study by J. W. Thomas Byrd, MD, and Kay S. Jones, MSN, RN, published in the American Journal of Sports Medicine, found that 95% of professional athletes returned to their previous level of sports competition.

Doing the surgery and coming back in December seems like a good option, but I've got to think multiple surgeons know what they're doing.
« Last Edit: September 08, 2017, 10:06:57 PM by Roy H. »


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Offline GreenFaith1819

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Don't give up, IT4.

https://www.youtube.com/watch?v=oRWZgsTzipA

Don't stop running. Get well.

Get your Brinks.

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Offline tarheelsxxiii

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I'm going to create a GoFundMe campaign or KickStarter with a goal of $30 million. 
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I'm going to create a GoFundMe campaign or KickStarter with a goal of $30 million.

For who? A man who is already richer than most people? He doesn't need it. Make it for people who are not going to eat today or something.


You probably meant it as a joke, disregard my comment if so.
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Offline playdream

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Didn't find one study of non-surgical outcome (e.g., rehab, rest).

This is the oddest thing about the situation to me. Why rest when it seems normal to have surgery? Or do those studies only look at guys who ultimately decided on surgery? Do they ignore other players who've had a tear and then recovered without surgery?

We are all flying blind here. But that seems like an answerable question.

Rest is a pretty common recommendation. Anthony Davis, for instance, has played through a torn shoulder labrum for three years.

I saw that. But hip?
You don't put on you all upper body weight on your shoulder
Hip on the other hand...

Offline Vermont Green

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Other than confirming that no one really knows the prognosis for IT's hip, not even specialist Doctors that have examined him, I did not feel there was much to this article.  Yes, there is probably some arthritis, but they went on to say that he has been playing with that for years.  I don't buy the implication that there is some scandal here.

The decision to rest over surgery, could in hindsight, turn out to be the wrong decision.  It could also turn out that the rest approach works but just takes longer than the Doctors first thought.  But that is very different than the idea that IT got biased medical advice with the Celtics somehow pushing the doctors in one direction or another so they could trade him or whatever.

Not sure if any of the blog medical experts can comment on this but if IT wasn't not a professional athlete, wouldn't the protocol be to let the hip rest and heal as much as possible before surgery?  I feel that the only reason that you would rush to surgery would be in the case of trying to get an athlete back on the court but that would not be the best thing in terms of the patient long term recovery.

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Other than confirming that no one really knows the prognosis for IT's hip, not even specialist Doctors that have examined him, I did not feel there was much to this article.  Yes, there is probably some arthritis, but they went on to say that he has been playing with that for years.  I don't buy the implication that there is some scandal here.

The decision to rest over surgery, could in hindsight, turn out to be the wrong decision.  It could also turn out that the rest approach works but just takes longer than the Doctors first thought.  But that is very different than the idea that IT got biased medical advice with the Celtics somehow pushing the doctors in one direction or another so they could trade him or whatever.

Not sure if any of the blog medical experts can comment on this but if IT wasn't not a professional athlete, wouldn't the protocol be to let the hip rest and heal as much as possible before surgery?  I feel that the only reason that you would rush to surgery would be in the case of trying to get an athlete back on the court but that would not be the best thing in terms of the patient long term recovery.
Yes but tbh surgery takes a lot away from the original capabilities of the tendon, resting is riskier health wise but the tendon would be performing at a closer level to the original tendon than surgery. At least that's what I've heard about, take it with a grain of salt.

Offline IDreamCeltics

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Didn't find one study of non-surgical outcome (e.g., rehab, rest).

This is the oddest thing about the situation to me. Why rest when it seems normal to have surgery? Or do those studies only look at guys who ultimately decided on surgery? Do they ignore other players who've had a tear and then recovered without surgery?

We are all flying blind here. But that seems like an answerable question.

Yeah, I thought there'd be at least one study of rehab without surgery, but I only came across arthroscopy studies.  Seems like there's too much variability in severity, need for treatment, treatment type, etc. to even speculate about one player. I do think he probably just wants to play through it because it's a contract year, though.

This took me all of 10 seconds to find with a google search.

http://www.jospt.org/doi/full/10.2519/jospt.2011.3225

Maybe you didn't find it because of the name of the article?

"Nonsurgical Treatment of Acetabular Labral Tears: A Case Series"

Offline mmmmm

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Didn't find one study of non-surgical outcome (e.g., rehab, rest).

This is the oddest thing about the situation to me. Why rest when it seems normal to have surgery? Or do those studies only look at guys who ultimately decided on surgery? Do they ignore other players who've had a tear and then recovered without surgery?

We are all flying blind here. But that seems like an answerable question.

The problem with the ESPN article is that the comps it uses are all players who HAD SURGERY.

It doesn't (and for reasons it notes in passing) have any data on players with hip labrum issues who did not need (or at least elected not to have) surgery.   Because that information isn't normally public.   It's hard for an athlete to hide the fact that he just had surgery.   But players rest and recuperate innocuously all the time.   And hip issues are often signaled as knee and/or lower back issues so often times players could have publicly described their non-surgery-requiring hip issue as a 'sore knee' or 'sore back'.  So players may innocently be 'hiding' his hip issues when he announces he has a knee or back issue instead.

So there simply isn't going to be any useful set of data about non-surgical recovery from hip issues.

It's a wild notion, I guess, but if a player has surgery for an injury, it is usually because it is  considered a worse injury than when a player does not undergo surgery.   So using those players as 'comps' to anticipate Thomas' future would seem like a pretty poor analysis.

Further, surgery itself, regardless of the injury, imposes trauma that is itself something that has to be recovered from.

I've had to learn a lot about hip issues in recent years due to my own hip injury and one thing I know for certain is that there is a gigantic, wide spectrum of possibilities here and that article only talks about the more serious, worse case part of the spectrum.

Unless someone has access to Thomas' actual medical information, there is simply no way for someone to know how his recovery will proceed.    None of the doctors in the article have ever examined Thomas or have had access to his x-ray & MRI scans.    But hey, they got to see their names in an ESPN article!  And maybe even get called up (paid) for a talking-head panel on TV!

Now, I'm not trying to minimize what the possible worst outcome may be for Thomas.  And I'm not going to predict that he'll come 100% back by late November.    All I'm saying is that there really is no information presented here or elsewhere that allows us to make any sort of prediction regarding Thomas.

The only information we have that's remotely close to a direct source is the things Thomas himself has said and you'll just have to decide for yourself whether he is honestly repeating what his doctors (who HAVE examined him) have told him.  We do know that at a minimum, they did not have consensus that he _should_ have surgery.  Because he didn't (At least not yet.).   Those are all positives for him.

That said, the implication (by the trade) that Danny was concerned about it and that he's acknowledged he'll miss at least the start of the season are negatives.

We don't really have anything more than that.

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