Hip arthroscopy

Figure 6. Diagram of the bony pathology of both cam and pincer impingement.

Figure 7. A complex labral tear. An arthroscopic probe is seen at the junction of the labrum and acetabular rim.

Figure 3. Fluoroscopic picture showing a mild amount of distraction of the hip before insertion of any instruments.

Figure 4. A needle is passed into the joint, breaking the ‘suction seal’, and allowing further distraction of the hip joint with minimal extra traction.

Figure 5. Portal placement under direct vision. The instrument is entering the joint through the hip capsule, between the femoral head (on the left) and acetabular labrum (on the right).

Figure 8. Cartilage delamination. A small area of acetabular cartilage has lifted from the underlying bone, being demonstrated by use of the arthroscopic probe.

Hip arthroscopy is a minimally invasive surgical procedure used to diagnose and treat problems within the hip joint. This procedure involves the use of an arthroscope, a small camera that allows the surgeon to view the inside of the joint on a video monitor. Hip arthroscopy is commonly used to treat conditions such as labral tears, femoroacetabular impingement (FAI), and hip dysplasia.

Indications

Hip arthroscopy is indicated for a variety of hip conditions, including:

• Labral tears: Damage to the ring of cartilage (labrum) that follows the outside rim of the socket of the hip joint.
• Femoroacetabular impingement (FAI): A condition where extra bone grows along one or both of the bones that form the hip joint, giving the bones an irregular shape.
• Hip dysplasia: A condition where the hip socket does not fully cover the ball portion of the upper thighbone, which can lead to joint dislocation.
• Synovitis: Inflammation of the synovial membrane, which lines the joint.
• Loose bodies: Small fragments of bone or cartilage that become loose and move around within the joint.
• Hip joint infections.

Procedure

During hip arthroscopy, the patient is typically placed under general anesthesia. The surgeon makes small incisions around the hip area to insert the arthroscope and other surgical instruments. The arthroscope transmits images of the inside of the hip joint to a monitor, allowing the surgeon to diagnose the problem and perform necessary repairs.

Common procedures performed during hip arthroscopy include:

• Debridement: Removal of damaged tissue.
• Repair or removal of the labrum.
• Trimming or reshaping of bone spurs.
• Removal of loose bodies.
• Treatment of cartilage damage.

Recovery

Recovery from hip arthroscopy varies depending on the specific procedure performed and the patient's overall health. Generally, patients can expect to:

• Use crutches for a few weeks to avoid putting weight on the hip.
• Participate in physical therapy to restore strength and mobility.
• Return to normal activities within 3 to 6 months.

Risks and Complications

As with any surgical procedure, hip arthroscopy carries certain risks, including:

• Infection
• Blood clots
• Nerve or blood vessel damage
• Persistent pain or stiffness
• Complications related to anesthesia

Related Pages

• Arthroscopy
• Hip replacement
• Orthopedic surgery
• Labral tear
• Femoroacetabular impingement
• Hip dysplasia

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