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Hip Preservation Surgery Keeps Young Athlete in the Game

Chase Payne
High school baseball player, Chase Payne, could barely walk due to a debilitating hip condition. Arthroscopic surgery to repair, reshape and preserve his hip joint got him back on the field.

Just a few hours after Chase Payne got his surgeon’s clearance to play baseball on a limited basis as a designated hitter, he batted the game-winning hit.

"I muscled it in to right field and brought the guy on second base in," said Payne, a pitcher and centerfielder for the Lexington High School Minutemen in Lexington, Ill.

Richard W. Kang, MD, MS, and Chase Payne Richard W. Kang, MD, MS, and Chase Payne at a follow-up appointment.

Following the game, the 17-year-old quickly emailed University of Chicago Medicine orthopaedic surgeon, Richard Kang, MD, MS, to report the news. "He was very excited for me," Payne said. A month later, Kang approved a full release for the rest of the season.

Payne’s hip trouble started in 2013, while he was attending a summer baseball camp at Florida State University. He dove into base and felt "something weird in my back," he recalled. "I was confined to a bed for the rest of camp."

Doctors in Florida and in Illinois thought it was a back injury. But when a spine surgeon in Peoria, Ill., determined the problem was in Payne’s left hip, he referred him to Kang, an expert in hip preservation.

"The first time I saw Chase, he could barely walk," Kang said. "He couldn’t take a step without debilitating pain."

CT scan of Chase Payne's FAI CT scan: The arrow points to a cam lesion, which is excess bone on the head-neck junction of the femur bone. A circle marks the os acetabuli, an unfused fragment of bone in the hip socket. As a result of this condition, Payne's hip bones did not rotate smoothly, leading to joint damage and pain.

Kang diagnosed Payne with femoroacetabular impingement (FAI), also called hip impingement. Because the bones in Payne’s hip had structural abnormalities, the ball of the thighbone was striking the edge of the hip socket. The resulting friction had damaged the joint and torn the labrum (a ring of cartilage in the socket).

"Exercise does not cause FAI, but we see it in young athletes because they perform more extreme pivoting maneuvers while playing rigorous sports," said Kang, noting that Payne also plays golf and basketball. FAI can lead to early arthritis and the need for a hip replacement.

In January 2014, Kang performed arthroscopic surgery on Payne’s hip. Using minimally invasive tools, he removed loose bone and repaired the labral tear. Kang then reshaped the ball and socket so that the thighbone would no longer hit the edge of the hip socket. "The goal of the surgery is to relieve pain while preserving the hip joint and its function," he said.

Payne progressed well and was able to bear weight two weeks after surgery. Anxious to get back on the field, he followed Kang’s strict protocol for recovery, returning to his team in three months. A local sportswriter credited him with breathing new life into the Minutemen.

"My hip feels amazing," said Payne, who dreams of playing baseball for the Division I Florida State Seminoles. "I have more range of motion and I am not afraid to do any type of movement. I think the hip is actually better power-wise. I am better than 100 percent."

October 2014

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