What is hip arthroscopy?

Hip arthroscopy is a procedure in which a small camera called an arthroscope is inserted into the hip joint so a surgeon can have a clear view of the inside. This cutting edge procedure has created new options for patients with hip pain, hip injuries, and early arthritis of the hip. Hip arthroscopy is a far less invasive, outpatient procedure with minimal risks. It is an alternative option to open surgery, which has significant risks of complications.

When is hip arthroscopy needed?

Hip injuries are common in people of all ages, not just the elderly. Young patients may go undiagnosed for years or be misdiagnosed with a number of other possible issues. Hip arthroscopy may be recommended if you have a painful, non arthritic condition that has not responded to non-surgical treatments that reduce inflammation. Inflammation causes swelling, pain, and stiffness in injured or diseased hip joints.

Hip arthroscopy may relieve painful symptoms that may be the result of a damaged labrum, articular cartilage, or other soft tissues that surround the hip joint. There are several orthopaedic conditions that can lead to these problems besides an injury, including:

• Femoroacetabular impingement (FAI): Bone spurs (bone overgrowth) form around the socket or femoral head and cause damage.
• Labral tears: Tearing of the soft tissue liner that may require repair or trimming.
• Snapping hip syndromes: Tendon rubs across the outside of the joint. Often this snapping or popping is harmless and does not need treatment, but in some cases the tendon is damaged from repeated rubbing.
• Synovitis: Inflammation of the tissues around the joint.
• Loose bodies: Fragments of bone or cartilage that become loose and move around within the joint.
• Hip joint infections

Procedure

At the beginning of the procedure, the hip will be pulled away from the socket just enough for the surgeon to insert instruments for treatment and see the entire joint. The surgeon will then make a buttonhole-sized puncture in your hip to insert the arthroscope. Using the arthroscope, the surgeon can view the inside of the hip to identify the damage. Other instruments will be inserted through separate incisions to begin treating the problem. Depending on the diagnosis, several different procedures can be performed, including:

• Labral repair or debridement
• Trim bone spurs caused by Femoroacetabular Impingement (FAI)
• Release of tight muscles
• Remove inflamed synovial tissue
• Smoothing off torn cartilage

The procedure length is determined by what the surgeon finds and how much needs to be done.

Recovery

Any surgery in the hip carries a small risk to the joint and the surrounding nerves or vessels, but complications from hip arthroscopy are uncommon. Any numbness caused by stretch nerves from the leg traction is temporary.

There is typically a one to two hour recovery time before being discharged. Someone will need to drive you home and stay with you for at least the first night.

A rehabilitation plan is developed by the surgeon based on the procedure that was performed. Crutches or a walker may be needed. Physical therapy will be necessary in most cases to help restore strength and mobility as well as a guide for additional do’s and don’ts during the rehabilitation process. Most patients will require a brace to limit motion. Usually medication is provided for pain control and to minimize complications.

To find out if this procedure is right for you, please contact Iowa Ortho at 515-247-8400 to set up an initial visit with Dr. Steven Aviles.