When is hip arthroscopy recommended?
Non-surgical treatments such as rest, physical therapy, medications, and injections are usually the first line of treatment for most hip conditions. However, your doctor might suggest hip arthroscopy if your condition does not respond to any of those treatments.
Hip arthroscopy can help to relieve pain caused by problems that damage the labrum, articular cartilage and other soft tissues surrounding the joint.
Some common orthopaedic conditions that can lead to problems that may require hip arthroscopy include:
- Femoroacetabular Impingement (FAI) – a disorder where there is a bone overgrowth (along the acetabulum or on the femoral head) that damages the soft tissues of the hip during movement.
- Dysplasia – a condition in which the hip socket is abnormally shallow and results in more stress being placed on the labrum to keep the femoral head within the socket, making the labrum more susceptible to tearing.
- Snapping hip syndromes – snapping or popping around the hip due to muscle tendons rubbing again bone during movement, resulting in pain and inflammation.
- Synovitis – a condition in which the tissues surrounding the joint become inflamed.
- Loose bodies – fragments of loose bone or cartilage that are trapped within the joint.
- Hip joint infection – when germs get into the joint and reproduce, causing an infection.
Surgical procedure
Positioning
- Your orthopaedic surgeon will put your leg in traction so that your hip is pulled away from the socket. This allows your surgeon to insert instruments, see the entire joint and perform the surgery.
Procedure
- Your orthopaedic surgeon will make a small keyhole incision (portal) in the skin to insert the arthroscope into the hip to view and identify the damage. Sterile fluid is pumped into the joint to inflate the joint and ensure good visualisation.
- Images from the arthroscope help your orthopaedic surgeon to evaluate the joint before proceeding with any specific treatments.
- Other small instruments will then be inserted through separate keyhole incisions to repair the torn labrum or damaged cartilage, trim bone spurs, reshape the acetabular and femoral head-neck so they fit each other better and remove inflamed tissues.
- Specialised instruments may be used for shaving, cutting, grasping, burring, inserting implants (suture anchors) or grafts, suture passing and knot tying.
- The length of the procedure depends on the number of things to be worked on.
- Incisions will be stitched or covered up with skin tapes, followed by an absorbent dressing.
HIP ARTHROSCOPY
Hip Arthroscopy Commonly Asked Questions
Planning for the Surgery
Your orthopaedic surgeon may recommend consulting your primary doctor or anaesthetist to assess your general health to identify any problems or health risks that may interfere with the surgery.
A hip arthroscopy usually requires only an overnight hospital stay if you are generally healthy.
Consult your orthopaedic surgeon for specific instructions but you may have to stop taking traditional medicine, blood thinning medications and control your general medical conditions before the surgery.
Hip arthroscopy is commonly performed under general anaesthesia (put to sleep), which may be supplemented with nerve blocks or injections of local anaesthetic to reduce pain. Your orthopaedic surgeon and anaesthetist will discuss the best method with you.
A hip arthroscopy will typically take between one to three hours, depending on the severity of your condition and the procedures that need to be done.
Complications
Complications are uncommon but all hip surgeries carry a small risk of injury to the surrounding nerves, blood vessels or joints. There are also small risks of infection, fracture, and blood clots forming in the veins. The traction used during surgery might stretch nerves and cause temporary numbness, but this usually recovers spontaneously.
Recovery
Feeling some pain is part and parcel of the healing process after surgery. Rest assured that your doctor will prescribe medications for short-term pain relief.
Paracetamol, non-steroidal anti-inflammatory drugs, and opioids are common temporary pain relief medications that will be prescribed. Your doctor might also recommend aspirin or other blood thinning medication to reduce the risk of blood clots in the veins.
You may have to use crutches after hip arthroscopy, and they are needed until the limping stops. In a more extensive procedure, crutches may be needed for one to two months to allow the labrum or cartilage to heal. Your doctor will also provide you with a rehabilitation plan which includes specific exercises to help you restore strength and mobility, as well as the dos and don’ts. You should keep your dressings clean and dry to avoid the risk of infection.
