Innovation saves some from hip replacement

Because Dr. Marc Philippon is not one to brag, someone else will have to tell you that the list of private numbers in his cell-phone memory would be the envy of any sports agent or fan.

"We were discussing Greg Norman's line of wines over dinner and the possibility of promoting the wines at our restaurants," said Chicago-area restaurateur Joe Carlucci, a Philippon patient who hosted the doctor at Carlucci in Rosemont, Ill., in May when he was in town to speak at a medical conference. "The next thing I know, Greg Norman and I are talking on the phone."

After the two hung up, Philippon called 1998 Olympic gold medalist Tara Lipinski. He wanted to check on her.

"Dr. Philippon is always there for me," said Lipinski, 20, a professional skater who starts her next tour in December. "He is more than just my doctor. We're friends."

At the head-turning age of 37, Philippon has pioneered a form of arthroscopic surgery that is saving people from total hip replacements, not to mention career-ending injuries and untold hours of pain. He already has operated on hundreds of hip-pain patients (covered by health insurance plans) in addition to his roster of elite athletes. He actively trains other orthopedic surgeons in his techniques.

Most notably, Philippon has invented flexible instruments that afford access to areas of the joint previously thought impossible to reach.

One important point: Active people can suffer the same immobility as, say, the 70-something senior. Hip pain is not age-discriminatory when the body twists too many ways too many times.

If you need an idea of what it's like to live with chronic hip pain, imagine struggling every time you get out of a chair or shift sleeping positions in bed.

'I couldn't sleep'

"I kept trying to skate through the pain," Lipinski said. "But it got to the point where I couldn't bend down to tie my shoes. I couldn't sleep. I couldn't walk without a limp."

Norman said he remembers waking up the morning after his mid-2000 surgery -- at home already, -- and saying to his wife, "This is the first time in years that I'm going to be able to get out of bed without pain."

Miami Dolphins quarterback Jay Fiedler, 30, has twice benefited from the cutting-edge technique. Philippon performed an arthroscopic procedure on Fiedler's right hip (his throwing side) in 2000, weeks after Norman's surgery.

"My right side hurt when I planted my leg to throw," Fiedler recalled by phone during a recent break from practice. "Believe me, I've been around a lot of doctors. I could see Dr. Philippon knows what he was doing."

Operating on a quarterback and other football players presents at least one unique challenge compared with, say, fixing a golfer's hip.

"I watched some videotape of Jay's games after the first surgery," said Philippon, who is based at the University of Pittsburgh Center for Sports Medicine but has retained his original orthopedic clinic at Holy Cross Hospital in Ft. Lauderdale. "I have to admit, I winced at how much he gets hit."

Nonetheless, Fiedler's right hip stayed strong, and he enjoyed a breakout season in 2000. During the past off-season, Fiedler started experiencing pain in his left hip. Philippon performed arthroscopic surgery in late July, and the Miami quarterback was cleared to return to full-contact play on Aug. 8.

Philippon's patient list is filled with success stories of more than 60 professional athletes, dozens of top college athletes and elite amateurs, plus the hundreds of others who still want to play 18 holes or walk to the corner without mind-bending effort.

He sometimes performs total hip-replacement surgery when a patient's weakened bone density rules out arthroscopy. Even in these cases, his more flexible instruments allow for a single incision just barely longer than two inches.

Carlucci went to see Philippon early this year at the suggestion of Dr. Mark Bowen, an orthopedic surgeon at Northwestern University Medical School. Carlucci's arthritic hip had degenerated enough to cause frequent pain but wasn't severe enough to warrant total hip replacement.

Philippon performed the surgery in March. Depending on what Philippon does to the joint, some patients, including Carlucci, need to use crutches and apply no weight to the hip for up to six weeks. But by May the restaurateur was swinging a golf club and played throughout the summer without pain.

To educate himself, Philippon started playing golf more avidly upon meeting with Norman in 2000. Along with steadily improving his own game the surgeon realized why any golfer who "hits a lot of balls" could be putting an unnatural strain on the hip.

"All of the torque and forces are placed directly on the back hip right when you release from your backswing," said Philippon.

For now, one of Philippon's biggest achievements, with Norman acting as a sort of unofficial ambassador of arthroscopic hip surgery, is unearthing the fact that many golfers suffer from hip pain.

What surprised Philippon most was "none of the pro golfers knew what was wrong." "The biggest problem with golf- and other sports-related injuries is that without examination using the arthroscope, pain can be misdiagnosed as muscle strains or simple soreness," Philippon said.

Tara Lipinski can speak to the issue. She started seeking medical opinions when her pain worsened after winning Olympic gold. One doctor informed her she was suffering from severely pulled muscles.

"That clearly wasn't the case," said Lipinski, who had surgery in 2000. "It was a relief finally knowing what was wrong."