Hip Arthroscopy

November 12, 2012

Hip Arthroscopy

This is a surgical procedure used by physicians to determine the extent of damage to the hip joint.

An arthroscopy is a procedure carried out by a surgeon using a camera, a monitor and specialised miniature instruments. This small device is called an arthroscope and enables a surgeon to have a detailed look at the inside of a joint in order to diagnose and treat any problems that may have arisen.

Knee and shoulder arthroscopies are much more common than hip arthroscopy, which nevertheless has been a treatment option for many years.

Hip anatomy

The hip joint, like the shoulder, is a ball-and-socket-joint where the head of the thighbone (femoral head) fits into a socket like structure in the large pelvis bone.

In order to facilitate a smooth surface that enables the bones of a ball and socket joint to move without causing friction, the surface of the joint is coated in slippery articular cartilage. This cartilage is in turn ring-fenced by labrum that helps maintain stability.

Finally, the whole joint is surrounded by a capsule of ligaments that also encloses the synovial fluid – the fluid that acts a lubricating agent in joints.

Why a hip arthroscopy may be required

For anyone experiencing hip pain the first treatment will always be non-surgical – including rest, medication, or physiotherapy. Most hip pain is the result of inflammation caused by injury or disease.

Should a patient not respond to the non-surgical treatment program their doctor might well consider a hip arthroscopy to be necessary. Hip arthroscopy has been found to alleviate the pain associated with many of the problems connected to the hip and its’ surrounding structure.

Before surgery

Prior to any surgery your doctor will carry out a physical examination in order to identify any health issues which may be problematic during surgery. A full medical history will also be taken. In a patient who is otherwise in good health a hip arthroscopy may well be carried out as an outpatient procedure.

An anaesthetist will discuss the anaesthesia options with you, as a general anaesthetic is no longer the only option for this kind of procedure.

The procedure

In order that the surgeon may have ease of access to the entire joint and insert the necessary instruments to carry out the procedure the leg will be placed in traction.

Once the leg is safely in traction, the surgeon will create a small incision in the hip, which the arthroscope will pass through. Separate incisions will be made for the instruments. Once the surgeon has fully appraised the inside of the hip joint he or she will decide on the best course of action for the patient. This may include -

  • Smooth or repair any damaged cartilage

  • Trim any bone spurs

  • Remove any inflamed synovial tissue

Complications

Whilst any surgery involves some risk, complications from hip arthroscopy are uncommon but may include -

  • Injury to the surrounding structures or the joint itself

  • Temporary numbness in the nerves due the traction

  • Infection

  • Development of blood clots

Recovery and rehabilitation

If the procedure as gone well an outpatient can expect to be discharged after a couple of hours providing he or she has someone to stay drive him or her home and stay overnight.

Rehabilitation will include a period using either crutches or a walker at least until any limping has stopped.

A rehabilitation plan will have been developed with you before your discharge and will usually include some physiotherapy; this will include specific exercises to help regain strength and mobility. You will also be advised of the things that you should and should not be doing during the rehabilitation period.

Most people make a full recovery from a hip arthroscopy and are able to continue with all the activities they did prior to surgery, for others some lifestyle changes may be required in order to protect the joint.

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