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Friday, March 27, 2015 - Hip Arthroscopy Helps Road Warrior Ania Tyski Get Back In Action
It takes a lot to slow Ania Tyski down. The 30-year-old pharmaceutical publicist from Plymouth Meeting has made activity and exercise central to her life. When she's not running, she's cycling. When she's not cycling, she's hiking or rock climbing. When she's not doing any of those things, she's at CrossFit MontCo in East Norriton, lifting weights, doing pull-ups, and jumping onto high blocks, among other functional fitness exercises.

So finding out in the fall of 2013 that she needed hip surgery was "traumatic" for Tyski, who calls herself "as healthy as they come."

Road Block

It turns out that all of the activities she enjoyed—marathons, bike races, even a few "Tough Mudder" obstacle-course challenges—exacerbated Tyski’s "impingement," a condition in which a bad fit between the hip's ball-and-socket causes wear on the bone, tearing of the labrum (cartilage in the hip), and severe pain. In her case, a history of repetitive use (plus running back-to-back marathons two weekends in a row) pushed Tyski's impingement from silent and bearable to sudden agony. After finishing a half-marathon in Nashville, she felt "sharp, sharp pain in the groin area" and found herself unable to walk to her hotel. Despite laying off her activities for two months, Tyski was still in pain and unable to function.

Her case isn't unusual. When Tyski consulted Eric Kropf, MD, Director of Sports Medicine and an orthopaedic surgeon at Temple University Hospital, "within the first 15 minutes, he said 'I know what you have, I've seen it a hundred times.'" Hip impingement often happens to young athletes who push their physical limits and suffer an acute injury; but it’s also not uncommon in middle-aged people who constantly put a tremendous amount of use on the joint, such as delivery truck drivers.

Hip Check

In both types of impingement, the choice has traditionally been either hip replacement or accepting the pain and loss of functionality. But in the last 15 years, a third option has emerged: hip arthroscopy, or "scoping" for short. Surgeons such as Dr. Kropf can arthroscopically shave away the mismatched bone and repair the labral tear, buying patients a few decades of functionality before full joint replacement would need to be considered. "In the sports medicine world, it's a growing area," Dr. Kropf explains. "But there's a lack of awareness about hip arthroscopy. People often still assume they just have to live with their hip condition."

That's why Dr. Kropf is increasingly devoting his practice to specializing in hip arthroscopy and preservation, and trying to get the word out about the chance to save hips rather than replacing them. "In our sports medicine practice, every patient under 50 years old with hip pain should be considered for it," says Dr. Kropf, who is one of only a few surgeons in Philadelphia with considerable experience in the procedure.

Road to Recovery

As upset as she was that hip impingement was literally impinging upon her daily dose of fitness, Tyski was comforted by Dr. Kropf's approach. "The first question he asked me was, 'What do you want your result to be?'" she recalls. "I said, 'I want to get back to being able to run.' He was very open and honest, not sugarcoating. He's one of the best doctors I've ever had."

Dr. Kropf performed hip arthroscopy on Tyski in late 2013, and she quickly transitioned from a wheelchair to physical therapy and recovery. "Within two weeks," she remembers, "I was looking for excuses to get out the door, even if it was just a trip to Costco." Tyski stuck to her rehab plan in order to heal correctly, and describes her experience with Temple's physical therapy team as "fantastic."

The last year was a humbling one for this road warrior. During the initial phase of her recovery, she remarks, "I would see someone running on the street and start crying." Since then, Tyski has slowly built back some of her running stamina, but says she'll probably limit her endurance to the half-marathon level. Meanwhile, she has channeled her energies into cycling and CrossFit, participating in one bike race last fall. "I'm not trying to end up back on the operating table by pushing my luck," she points out.

Tyski also hasn't let recuperation get in the way of another goal. In a few months, she'll be doing some serious activity—that is, a wedding march. She and her fiancé are busy getting ready for the big day and are planning a honeymoon in Europe with "some biking, maybe hiking, tons of walking, and definitely a lot of eating." With her hip just about healed, Tyski is ready: "I'm completely okay walking down the aisle and dancing the night away!"