FAQs on Hip Arthroscopy
Over 70,000 hip arthroscopy procedures performed in the United States every year. According to the American Board of Orthopaedic Surgery, hip arthroscopy instances have increased by 600% from 2006 to 2010. With the use of cutting-edge equipment and technology, over 85% of patients treated for hip injuries return to their previous level with one to two years. Hip arthroscopy also plays a role in preventing the need for hip replacement.
What is hip arthroscopy?
Hip arthroscopy is a minimally invasive procedure to treat hip joint disorders. Arthroscopy refers to surgical repairing of damaged joints using a tiny fiberoptic camera and specialized instruments inserted through small incisions. In case of hip arthroscopy, surgeons make small cuts on the hip and the arthroscopic procedure is performed using medical instruments and guided by inserted tube-like camera.
Popularly known as key-hole technique, arthroscopy is commonly used to treat shoulder and knee joints. However, its use for hip joint is a relatively new method that has gained popularity in the last 8 to 10 years and more patients preferring it to avoid the large open incision.
A hip arthroscopy performed as an outpatient procedure is less invasive and ensures faster recovery. Advanced techniques, such as traction distraction is used to insert an arthroscope into the hip joint that was deeper than knee and shoulder joints. All is needed are just 2 or 3 small incisions through which camera and instruments reach the joint and perform the surgery.
What are conditions treated with hip arthroscopy?
- Inflammation, pain, and stiffness in a diseased hip joint
- Damage to labrum, cartilage, and soft tissues in and around the hip joint
- Femoroacetabular impingement caused by bone spurs in the hip joint
- Dysplasia leading labrum damage
- Snapping hip syndromes causing severe damage to tendons connected with the hip joint
- Chronic synovitis inflammation
- Excessive presence of bone or cartilage fragments in the hip joint (need for removal)
- Hip joint infection
- Labral and cartilage tears
- Ruptured ligamentum tears
- Hip diagnostic biopsy
- Chondral lesions
- Trochanteric pain syndrome
- Sciatic nerve compression
How does it help?
Arthroscopic hip surgery enables to repair damaged tissues, tears, and bones and remove loose bodies. This relieves pain and optimizes the stability of the hip joint. The procedure also prevents frequent inflammation caused by bone rubbing and checks progress toward osteoarthritis. With its successful use, patients can avoid total hip replacement and improve daily activities.
Who is a candidate for hip arthroscopy?
Hip arthroscopy is suggested to patients across different age groups subject to the following conditions.
- Hip joint pain cannot be managed with non-surgical methods
- Continued inflammation, pain, and stiffness in the hip for more than a year
- Progression toward hip joint degenerative disorders, such as osteoarthritis
- Worsening labrum damage and contact between femur and hip socket rim
- For diagnosis of hip joint disorder
How is hip arthroscopy performed?
The patient is placed under general anesthesia. Surgeons prefer either of two patient positions – supine (sleeping on the back) or lateral decubitus (sleeping on the side) – to perform the surgery. To gain access to the hip joint, the affected leg is put in traction or the hip bone is pulled away a few millimetres from the joint to make space to insert the arthroscope and instruments. The amount of traction required for surgery is identified following fluoroscopic imaging.
A small keyhole equal to a buttonhole in size is made in the hip and the arthroscope is introduced to the joint through it to view the damaged area. A few more tiny keyholes are made to insert specialized surgical instruments and perform the surgery based on live arthroscopic images. The instruments and the camera are pulled out and the traction is released once the operation is complete.
Hip arthroscopy surgery involves the following procedures according to the need of the patient.
- Smoothening of torn cartilage
- Repairing and restricting of cartilage or labrum
- Trimming or removal of bone spurs
- Removal of bone or cartilage fragments
- Removal of synovial tissue
- Relieving pressure from nerves
How long does hip arthroscopy surgery take?
It takes between one to two hours to complete the procedure depending on complexities.
Do I need to stay at the hospital after hip arthroscopy?
Patients are kept in the ward for 3 to 4 hours. While many of them prefer an overnight stay in the hospital, some go home after the observation period.
Do I need rest after hip arthroscopy?
You should take rest for a week and join non-stressful jobs after that. Use crutches for two weeks to avoid any discomfort. Use a brace until six weeks. Don’t bear weights for first three weeks except those prescribed by your therapist.
What are the restrictions following hip arthroscopy?
- Keep the operated area away from water for two days
- Avoid driving for three to four weeks
- Take rest for the first week
- No weight bearing for three weeks. 50% after three weeks, 100% after six weeks
- Use crutches for two to three weeks
- No activity beyond the tolerance level
What kind of rehabilitation is needed following hip arthroscopy?
- Day 1 to 7: Isometric quadriceps, Hip mobilization, movement of hamstrings, gentle joint distraction, balancing, etc.
- Week 2 to 6: Increase the range of motions, work out on stationary bike, limited progressive resistance training, etc.
- Week 6 to 10: Added flexibility workouts, running, more resistance and functional strengthening workouts, limited weight bearing, etc.
- Week 10 to 12: Competitive sports training, intense strengthening, etc.
How long is the recovery period following hip arthroscopy?
The physical pain and incisions heal within one to two weeks. Healing picks up after third week. Visible improvement is experienced in five to six weeks depending on complexity of surgery. You can return to work in two to three weeks and have all types of hip movements after six weeks. Patients can return to their previous ability in a year.
What are the potential complications of hip arthroscopy?
Patients reportedly experienced anesthesia and surgical complications, including bleeding, nerve damage, and infection, after the surgery. However, these can be avoided by following the right surgery protocol.
Villar, R.N. Hip arthroscopy. Br J Hosp Med. 1992;47:763–766.
McCarthy, J.C., Busconi, B. The role of hip arthroscopy in the diagnosis and treatment of hip disease. Orthopedics. 1995;18:753–756
Gedouin, J. et al (2010). “Assessment of arthroscopic management of femoroacetabular impingement. A prospective multicenter study”. Orthopaedics & Traumatology: Surgery & Research 96 (8): S59–S67
Enseki, K.R., et al. The hip joint: arthroscopic procedures and postoperative rehabilitation. J Orthop Sports Phys Ther. 2006;36:516–525.
Glick, J.M. Hip arthroscopy using the lateral approach. Instr Course Lect. 1988;37:223–231.
Holgersson, S., Brattstrom, H., Mogensen, B. et al, Arthroscopy of the hip in juvenile chronic arthritis. J Pediatr Orthop. 1981;1:273–278.
Philippon, M.J.et al, Early outcomes after hip arthroscopy for femoroacetabular impingement in the athletic adolescent patient: a preliminary report. J Pediatr Orthop. 2008;28:705–710.
Sampson, T. (2011). “Arthroscopic treatment for chondral lesions of the hip”. Clinics in sports medicine 30 (2): 331–348.
Guanche, C.A., Bare, A.A. Arthroscopic treatment of femoroacetabular impingement. Arthroscopy. 2006;22:95–106.
McCarthy, J.C., Lee, J.A. Arthroscopic intervention in early hip disease. Clin Orthop Relat Res. 2004;429:157–162.