The development of hip arthroscopy has evolved considerably in the last 10 years. From a technical standpoint, this is much more challenging to perform than knee or shoulder arthroscopy. The reason for this is the hip joint has limited entry points and lies deep within layers of muscle. Surrounding this is a plexus of nerves and vascular structures.
Hip arthroscopy may be recommended for number of reasons. For those who have hip pain but a cause has not been identified on diagnostic imaging studies, a diagnostic hip arthroscopy can be performed to further investigate the patient’s complaints. More commonly, hip arthroscopy is used to treat conditions such as:
- Femoroacetabular impingement – condition in which abnormal contact between the ball of the femur and the hip socket (acetabulum) may lead to bony overgrowth and damage to the articular cartilage and/or labrum. Several recent studies have shown good short outcomes (up to 5 years) and high patient satisfaction for patients who underwent hip arthroscopy for this condition.
- Loose bodies within the joint – Retained fragments of bone or soft tissue that are free floating in the joint.
- Synovitis – Refers to inflammation of the lining surrounding the hip joint.
- Torn acetabular labrum – The hip labrum can become torn from injury or can be associated with femoroacetabular impingement.
- Tendon / Ligament tears – Abnormal wear leading to repeated tendon rub can result in pain. An injury to the Ligamentum Teres from a fall or twisting event can also cause significant hip pain and instability
This surgery is performed on an outpatient basis. General anesthesia is most common but a regional block may also be used.
The surgeon will make several small holes to allow placement of the arthroscope (camera) and working instruments. Through these small incisions the surgeon can shave off bone spurs, debride soft tissue, and repair or remove torn tendons and/or ligaments. The length of surgery varies based on the specific condition being addressed.
It is very common to feel discomfort and have swelling in the hip following the procedure. Additional advantages of hip arthroscopy over other surgical methods include an earlier start to physical therapy and a faster return back to activity.
Complications from this type of procedure are unlikely, but can occur. Risks include infection, bleeding, injury to nerves and/or blood vessels, fractures, and blood clots in addition to risks associated with anesthesia.