Hip Arthroscopy Specialist

Effective planning leads to successful hip arthroscopy. This involves several preparatory steps to ensure patient safety and optimal surgical outcomes.

• Health Assessment: This assessment is conducted by the hip surgeon to identify any potential health risks that might interfere with the surgery.
• Medication Review: Patients need to inform their hip surgeon about all medications and supplements they are taking. Some of these may need to be temporarily stopped before the surgery to reduce risks such as excessive bleeding.
• Anaesthesia Plan: The surgery is commonly performed under general anaesthesia, though regional anaesthesia, such as spinal or epidural, may also be used. The choice of anaesthesia is determined after a discussion between the patient and the hip surgeon.
• Pre-operative Planning: These include guidelines on when to arrive for the surgery and directives on fasting before the procedure.

The surgical procedure of hip arthroscopy involves several key steps:

1. Positioning and Traction
Initially, the patient’s leg is placed in traction, meaning the hip is gently pulled away from the socket. This allows the hip surgeon to insert instruments and view the entire joint.

2. Incision and Arthroscope Insertion
The hip surgeon makes a small keyhole incision, or portal, in the skin to insert the arthroscope into the hip. Sterile fluid is pumped into the joint to inflate it for better visualisation.

3. Joint Evaluation
Images from the arthroscope, displayed on a video monitor, assist the hip surgeon in evaluating the joint and identifying any damage.

4. Treatment Procedures
Depending on the diagnosis, the hip surgeon may perform a variety of procedures, such as repairing the torn labrum, trimming damaged cartilage, reshaping bone structures for better fit, and removing inflamed tissues. This is done using specialised instruments inserted through separate keyhole incisions.

5. Instrumentation and Techniques
Hip surgeons use specialised instruments for tasks like shaving, cutting, grasping, burring, and suture passing. In some cases, implants (such as suture anchors) or grafts may be used.

6. Closure
After the procedure, incisions are typically stitched or covered with skin tapes, followed by an absorbent dressing.

The length of the procedure varies depending on the extent of the damage and the number of issues addressed.

While hip arthroscopy is often an outpatient procedure, requiring no overnight hospital stay, some cases might necessitate a short hospital stay, especially if the patient has certain health conditions.

The recovery process following hip arthroscopy involves several aspects:

• Pain Management: Postoperative pain is a normal aspect of the healing process. Patients are typically prescribed medications for short-term pain relief, which may include paracetamol, non-steroidal anti-inflammatory drugs, and, in some cases, opioids.
• Avoiding Surgical Complications: The hip surgeon may prescribe aspirin or other blood thinning medication to reduce the risk of blood clots.
• Restoring Strength and Mobility: Rehabilitation includes specific exercises aimed at restoring strength and mobility. The plan is tailored to the individual’s needs and the nature of the surgery performed. To support walking, some patients may need to use crutches until they stop limping. The duration can vary from a few days to one or two months, especially in cases where extensive repair is necessary.
• Taking Care of the Surgical Site: Keep the dressings clean and dry to prevent infection and promote proper healing of the incision sites.
• Gradual Resumption of Activities: Patients should resume their normal activities gradually, following the guidance of the hip surgeon.

The long-term outlook after hip arthroscopy is generally positive, with many patients returning to full, unrestricted activities. The specific recovery time and outcome depend on the type of hip damage treated and the patient’s overall health.