Your guide to hip arthroscopy
One option that’s available to orthopaedic patients is hip arthroscopy. But what is it, who needs it and why should you consider it? Dr Dan Fick offers some answers.
What is hip arthroscopy?
Hip arthroscopy is a type of keyhole surgery that enables your orthopaedic surgeon to view your hip joint without the need for a large incision.
Dr Dan Fick says:
“We find arthroscopy a useful procedure to diagnose and treat a wide range of hip problems. The process is usually very straightforward, your time in hospital is short and you should recover quickly afterwards.”
What is hip arthroscopy used for?
In a healthy hip, the ball of the thigh bone (femoral head) fits perfectly in to the hip socket (acetabulum).
“A healthy hip is a ball and socket joint and it all fits perfectly together, and the joint is surrounded by soft tissue. The joint surfaces are covered by smooth articular cartilage that helps the bones glide across each other. Bands of ligaments surround the joint to keep it strong and help hold the joint together. If something goes wrong with your cartilage or ligaments, hip arthroscopy could help.
“Another part of the hip that can be damaged and torn is the labrum. The labrum is very strong cartilage that fills the space around the acetabulum (hip socket), which improves joint stability. Again, hip arthroscopy can be useful if we need to fix damage to the labrum.”
Hip arthroscopy could be an option if you have:
• fragments of bone or cartilage that become loose and move around within the joint – we can clean out the joint
• synovitis – inflammation around the joints
• ruptures to the tendons around the joint
• sciatic compression of the nerves affecting the hip
• tendon problems such as snapping hip syndrome, in which the tendon rubs outside the joint and becomes damaged from repeated friction – you might hear a popping or clicking sound when your hip moves.
What happens during hip arthroscopy surgery?
“During hip arthroscopy, I will make 2 small incisions around your hip joint. These small incisions serve as entry points for the arthroscope (a tiny camera) and specialised instruments allowing me to visualise the inside of your hip joint on a monitor in the operating room. This visual inspection helps diagnose the issue. We close your skin with sutures and a waterproof dressing is applied. A compression dressing is put on over the wounds to help reduce the swelling. Hip arthroscopy is a minimally invasive day-patient procedure, so you won’t even need a night in hospital.”
What are the benefits?
Hip arthroscopy is a type of joint preservation surgery, as opposed to joint replacement surgery. The goal is to fix up any damage to your own joints to reduce joint pain and help you regain your mobility.
“Because hip arthroscopy is a type of keyhole surgery, your recovery time will be shorter than if you had open surgery like we use for hip or knee replacements,” Dan explains.
“This results in less pain and joint stiffness for you so you will very quickly be able to return to doing the things you love.”
What is recovery like?
“This can be very variable. You may experience a mild ache in the ankle and/or knee and occasionally numbness in the thigh and perineum. This is due to the mild traction to the leg and will settle. You may need crutches for the first 10 days, but our goal is to get you walking as normally as possible as quickly as possible.
“We recommend 2 days of absolute rest at home then 2 weeks of gentle activity only. Avoid deep flexion past 90 degrees and any rotation that causes pain. Avoid long walks and hills. Do not indulge in heavy or prolonged activities or sports. Many people benefit from performing some light strengthening exercises – such as using an exercise bike with no resistance – once the wound has healed. You can usually return to work after 2 to 3 weeks.”