Hip Arthroscopy

A Hip Arthroscopy is a minimally invasive surgical (MIS) procedure used to investigate, diagnose and treat a hip disorder that fails to respond to physiotherapy, medication or other non-surgical treatments. This procedure provides a surgeon with a quick, easy and clear view of the inside of the hip through a pencil slim, high-resolution camera known as an Arthroscope. There are two types of hip Arthroscopy a) Diagnostic Arthroscopy (investigation to find out what is wrong with a hip joint) b) Therapeutic Arthroscopy (correction of an injury or fault within the hip joint). It is most common for these procedures to be provided at the same time.

Hip Arthroscopy is usually performed in order to investigate and relieve persistent hip pain, swelling, clicking, catching, instability or 'giving way' of a hip joint. This is an increasingly more common orthopaedic procedure provided in A+ clinic now-a-days, especially for the younger patient with hip problems deemed too young to contemplate a Hip Resurfacing or Replacement procedure.

The majority of Arthroscopies are performed on candidates between the age range of 20 and 60 years in order to investigate and treat sports injuries, work related injuries, arthritis or general inflammation and 'wear and tear'.

A Hip Arthroscopy can be performed under General Anaesthetic (you will be asleep), Epidural or Regional Anaesthetic (you will be awake). The procedure usually takes only a short amount of time to perform if the injury to the hip is of a minor nature (approximately 30 minutes), although repair of more complex injuries can take much longer. Most Arthroscopy procedures are provided on a Day-Case basis.

During the procedure two small incisions just a few millimetres in length are made either side of the problematic hip. These two incisions (cuts) allow a narrow tube with a camera within it to be inserted into one and a slim tube that will regularly inject fluid and rinse the inside of the hip into the other. The injected fluid will allow the Consultant Surgeon to get a good view of the problem area via the camera lens as he moves it around the inside of the hip joint. Once the problem is properly identified, another small incision can then be made elsewhere on the hip surface (sometimes two incisions are made) in order to insert exceptionally fine and narrow instruments into the problematic hip joint space. With the aid of clear vision via the camera, the Consultant Surgeon can then guide his fine instruments and gently correct the injury or problem without any need to fully open up the hip. Common corrective procedures performed during an Arthroscopy are:

• Drainage of inflamed joint fluid
• Removal of torn or loose fragments of cartilage
• Removal of loose fragments of bone.

At the end of the procedure the small wounds on the knee are usually closed with a simple sticky dressing and absorbable stitches.

Once a patient is fully recovered from the effects of anaesthetic they are normally quickly encouraged to be as active and mobile as possible to avoid complications such as joint stiffness and Deep Vein Thrombosis from developing. It is therefore normal for patients to be encouraged to undertake physiotherapy exercises and walk up and down stairs and a gentle distance just a few hours after surgery. Following a progressive improvement of mobility and pain control, patients are normally discharged home four to six hours after their surgery. By the time the required level of recovery is achieved for discharge, patients are normally wearing only a simple wound dressing over their incisions, eating and drinking normally, walking unaided and taking only mild analgesia (pain killers) to control any pain.

Over the next six weeks patients will be expected to work on improving their own mobility and range of joint movement through dedicated and progressive physiotherapy and by increasing their daily activity and walking distances. Your Consultant Surgeon will then assess your condition and joints range of movement after one week and then again after three months to evaluate how successful the Arthroscopy has been.

Patients who are in employment should not resume work until after their first consultation and dependant on the physical nature of their job may be advised to take longer off work. Patients should expect a continuous and full physical recovery to take up to six months to achieve.

Although Hip Arthroscopy surgery is very regularly performed without any complications occurring, it is very important that all candidates are fully aware of both the benefits and risks of undertaking such surgery. All surgery, no mater how expertly or carefully it is performed, carries risks and the importance of a full evaluation and consultation to discuss your condition in relation to these risks cannot be over emphasised.

At A+ clinic our Consultant Surgeons will carry out a full evaluation of your individual needs and circumstances, provide you with a comprehensive verbal and written explanation of your condition and recommend the most appropriate solution to improve your condition.
Our expert Consultant Surgeons understand the importance of the decision you are making when contemplating a Hip Arthroscopy. Throughout your consultation you will be encouraged to ask as many questions as you wish and to take your time in making a decision to proceed with any recommended treatment.

The nice part about hip arthroscopy is that it is much less invasive than traditional hip surgery. This means:

o Early rehab
o Accelerated rehab course
o Outpatient procedure
o Smaller incisions
o Early return to sport

• Labral Tear
  The labrum of the hip is a cuff of thick tissue that surround the hip socket. The labrum helps to support the hip joint. When a labral tear of the hip occurs, a piece of this tissue can become pinched in the joint causing pain and catching sensations.
• Loose Bodies
  Loose bodies are pieces of cartilage that form within the joint. They look like small marbles floating within the joint space. These loose bodies can become caught within the hip during movements.
• Snapping Hip Syndrome
  Snapping hip syndrome has several causes, some of which can be treated with hip arthroscopy. If something is catching within the hip joint, hip arthroscopy can be used to relieve this snapping. Also, hip arthroscopy can be used to perform a psoas tendon release in cases of internal snapping hip syndrome.
• Cartilage Damage
  In patients with focal cartilage damage, meaning not widespread arthritis, hip arthroscopy may be helpful. These patients may sustain an injury causing a piece of cartilage to break away from the surface of the bone. These patients may benefit from removal of that piece of cartilage.
• Early Arthritis
  This is a controversial topic, as patients who have arthritis pain generally will not benefit from a hip arthroscopy. The patients who tend to benefit have specific finding of impingement (pinching) within the hip joint, and may benefit from removal of the bone spurs causing this impingement. This is only possible in the very early stages of arthritis, and even then may not offer relief of symptoms.