Hip Arthroscopy

Arthroscopy (not to be confused with arthroplasty) is a surgical procedure that allows your orthopedic surgeon to see, diagnose, and treat problems inside a joint within your body. Your doctor may recommend hip arthroscopy if you have a condition that does not respond to non-surgical treatment but has not progressed so far as to indicate a total hip replacement is needed.2

Arthroscopy comes from two Greek words and literally means “to look within the joint.”1 During a hip arthroscopy procedure your surgeon makes a small incision near the hip joint and inserts an arthroscope, a slender telescope with fibre-optic lighting attached to a camera that displays the interior of the joint on a video screen. Your surgeon uses these images to guide small surgical instruments that aid in treating problems with your hip.2

Why Hip Arthroscopy is Performed

Hip arthroscopy can be used to treat conditions such as:

  • Femoroacetabular impingement (FAI) – a disorder where bone spurs (bone overgrowth) around the socket or the femoral head cause damage.
    Removing small fragments of bone or cartilage that become loose and move around within the joint.
  • Dysplasia – a developmental condition where the joint is abnormal from early infancy, becoming deformed and shallow with other associated damage occurring in adulthood such as a torn labrum.
  • Snapping hip syndromes – cause a tendon to rub across the outside of the joint. This type of snapping or popping is often harmless and does not need treatment. In some cases, however, the tendon is damaged from the repeated rubbing.
  • Synovitis – inflammation of the major lining of the joint called the synovial membrane.
  • Hip joint infection – also sometimes called a ‘septic hip’.

During the procedure you will be under anesthesia and your leg put into traction, which pulls the femur (ball) away from the acetabulum (socket) just enough to create an access point for the arthroscopic instruments. Several procedures may be performed during hip arthroscopy depending upon what your surgeon finds:2

  • Trimming or repairing torn cartilage
  • Trimming and smoothing bone spurs caused by FAI (see above)
  • Removing inflamed synovial tissue (joint membrane tissues)

Risks and Complications

Complications from hip arthroscopy are uncommon.2 Any surgery in the hip joint carries some risk of injury to the surrounding nerves or vessels, or the joint itself. The traction needed for the procedure can stretch nerves and cause numbness, but this is usually temporary.There are also small risks of infection, as well as blood clots forming in the legs (deep vein thrombosis).

Recovery

Once the anesthesia wears off and your doctor approves, you will be released to go home. Hip arthroscopy can be quite painful for a number of days post-op and may require the use of strong pain medications. You will be using crutches at first to get around and you will be encouraged to take it easy the first week and not put weight on your hip. After a few days, you will return to your doctor’s office to change the bandage and assess your progress.

As your recovery progresses, you will be encouraged to do some exercises to help strengthen the muscles surrounding your hip. If you feel pain, keep your exercise or activity only to a level of mild discomfort. Stop if you feel any pain. You should begin to feel better in a week or two and notice your pain greatly reduced.3

Outcomes

Many people experience a favorable outcome after hip arthroscopy and your results will depend upon the type of damage present in your hip before the procedure. For some, lifestyle changes will be needed to protect a fragile hip joint prone to further damage. Although hip arthroplasty is successful at treating a number of conditions, it may only be a stopgap procedure for some patients who may eventually require a total hip replacement.

Sources

  1. AAOS – American Academy of Orthopaedic Surgeons, “Arthroscopy” http://orthoinfo.aaos.org/topic.cfm?topic=a00109
  2. AAOS – American Academy of Orthopaedic Surgeons, “Hip Arthroscopy” http://orthoinfo.aaos.org/topic.cfm?topic=A00572
  3. Cedars-Sinai Orthopaedic Center, “Minimally Invasive Hip Arthroscopic Procedure” http://www.cedars-sinai.edu/Patients/Programs-and-Services/Orthopaedic-Center/Treatment/Minimally-Invasive-Hip-Arthroscopic-Procedure.aspx

image creditMercy Health

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