What is Hip Arthroscopy?
Hip arthroscopy is performed through small incisions using a camera to visualize the inside of a joint. Through several small incisions (about 1 centimeter each) your surgeon will insert a camera into one incision, and small instruments through the other incisions.
What is the benefit of hip arthroscopy compared to open surgery? The nice part about hip arthroscopy is that it is much less invasive than traditional hip surgery. This means:
- Early Rehab
- Accelerated Rehab Course
- Outpatient Procedure
- Smaller Incisions
- Early return to Sport
What are the most common conditions treated Arthroscopically?
Arthroscopy is used to diagnose and treat certain hip problems. If the source of your symptoms cannot be discovered from a physical examination and diagnostic studies, such as x-rays and magnetic resonance imaging (MRI), arthroscopy may be used. If nonsurgical treatment fails to bring improvement in your symptoms, your doctor may treat the condition arthroscopically. With arthroscopy, the doctor can remove bits of cartilage or bone that are loose in the joint. Arthroscopic surgery can also be used to repair or remove a tear in the hip cartilage (called the labrum) that is causing pain with “clicking” and “catching.” This was the condition for which Greg Norman was treated.
Hip arthroscopy can also be used to perform a biopsy, to treat osteoarthritis, and to treat synovitis (the inflamed lining of the joint) such as in a person with rheumatoid arthritis.
Who should not have this procedure?
Arthroscopic surgery cannot be used to treat all problems of the hip joint. For example, arthroscopy will not help you if you have severe osteoarthritis or a hip that is stiff due to a condition such as arthrofibrosis. Your doctor will not treat you arthroscopically if you have already had several open hip surgeries. Today, arthroscopy is used to diagnose and treat fewer conditions of the hip than other joints such as the shoulder and knee. However, most people have successful results from arthroscopic treatment.
What conditions can be treated with hip Arthroscopy?
- Labral Tear
The labrum of the hip is a cuff of thick tissue that surround the hip socket. The labrum helps to support the hip joint. When a labral tear of the hip occurs, a piece of this tissue can become pinched in the joint causing pain and catching sensations.
- Loose Bodies
Loose bodies are pieces of cartilage that form within the joint. They look like small marbles floating within the joint space. These loose bodies can become caught within the hip during movements.
- Snapping Hip Syndrome
Snapping hip syndrome has several causes, some of which can be treated with hip arthroscopy. If something is catching within the hip joint, hip arthroscopy can be used to relieve this snapping. Also, hip arthroscopy can be used to perform a psoas tendon release in cases of internal snapping hip syndrome.
- Early Arthritis
This is a controversial topic, as patients who have arthritis pain generally will not benefit from a hip arthroscopy. The patients who tend to benefit have specific finding of impingement (pinching) within the hip joint, and may benefit from removal of the bone spurs causing this impingement. This is only possible in the very early stages of arthritis, and even then may not offer relief of symptoms.
What are the possible complications from Hip Arthroscopy?
The most concerning complications of hip arthroscopy have to do with several important nerves and blood vessels that surround the joint. Nerve injury is uncommon, but can be a significant problem. The most commonly affected nerves include the sciatic nerve, the lateral femoral cutaneous nerve (sensation to the thigh), and the pudendal nerve. Injury to any of the nerves can cause pain and other problems.
Other possible complications from hip arthroscopy include potential injury to normal structures, infection, and continued pain after the surgery. The rate of these complications is low, but patients need to understand the potential prior to undergoing a hip arthroscopy.