Andy Murray 'Could Improve Further' After Queen's Success

Peter Russell

June 25, 2019

"I’ve won with a metal hip. It is mental really." With those words Andy Murray, who underwent hip resurfacing surgery earlier this year, summed up the achievement of winning the Queen's doubles title in London on Sunday with partner Feliciano López.

It was an astonishing achievement for the 32-year-old Scot who last won a singles title in February 2017.

Earlier this year, after limping through a 5 set defeat in the first round of the Australian Open, Murray admitted he was "struggling even with walking" and had no idea whether major surgery, that then looked increasingly inevitable, would allow him to compete again at the highest level.

Wind the clock on 5 months and following victory at the west London club during which he was pain free, the three-time Grand Slam champion has dared to contemplate a return to competing in singles tournaments.

Murray's impressive recent form has vindicated his decision to have surgery.

Prof John Skinner, a consultant orthopaedic surgeon, said that the Wimbledon champion could reasonably expect his hip resurfacing to last around 17 years, although the level of competition and training could impact on those expectations.

We asked Prof Skinner, a member of the British Orthopaedic Association Executive Committee, for an appraisal of Andy Murray's injury, performance, and future prospects.

Q&A

What's your assessment of Andy Murray's condition leading up to surgery?

For him to have end-stage arthritis at this stage, his anatomy would not be normal. He almost certainly either had dysplasia [or impingement].

You ideally want a ball in a deep cup. In mild dysplasia, you have a ball in a bowl, and in the worst type of dysplasia you have a ball in a saucer. I suspect he had a form of dysplasia. And what that does is concentrates the load on a smaller surface area so it wears out quicker.

Or, the other thing is impingement, where part of the neck of the femur rubs against the edge of the socket.

So, his anatomy wouldn't be normal because if you've got normal anatomy your hip generally lasts into your 60s and 70s.

And he's likely to have played with pain for some years because he would have had it from birth, and sportsmen with this type of thing tend to get a lot of groin strains, or pain in the groin.

So, he's likely to have had pain, particularly in the last 4 or 5 years, when he's achieved a lot.

Can you describe the hip resurfacing treatment that Andy Murray would have had?

The standard treatment would be a total hip replacement. If you think of the hip as a ball and socket joint, you cut the ball off completely and you put the stem into the bone. You prepare the socket and line it with a shell that can either be metal or plastic.

So, the difference between them: in the total hip replacement, you actually remove the ball part of the socket so you can fit the stem. With resurfacing, what you do is you shape the top of the ball and put a metal cap on top of it – so you retain it, and then you put a metal socket into the pelvis.

So, it is a metal on metal bearing. It's made of cobalt chrome.

It has shown fantastic results in young, active men.

And that would be an attractive option to a sportsman of Andy Murray's calibre?

Exactly right. The aim of hip surgery is to get people back to normal life.

The advantage of resurfacing is that the size of the ball is bigger because you're retaining something close to the size of the natural ball and socket. As a general rule, that makes it more stable because with extremes of movement, artificial joints can dislocate, but the resurfacing type are more stable.

So, that would be one of the things that led them to choose that implant for him.

Is playing doubles likely to be the extent of Andy Murray's tennis abilities now?

He's 5 months down the line. He will get better from here.

He's not fully rehabilitated yet. He's over the surgery but then it's about building up the small muscles around the hip, increasing his range of movement, and increasing strength.

He's obviously functioning at a high level but you'd expect him probably to improve up to a year.

I think that he has exceeded expectations at this stage but he's a remarkable guy. He's won three grand slams when it's probably been the most competitive era for men's tennis with Federer, Djokovic and Nadal. So, to do that, he's a supreme athlete.

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