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Minimally Invasive Hip Surgery

Minimally Invasive Hip SurgeryRecent development of highly specialized procedures and surgical equipment have lead to new options for patients with hip pain, hip injuries and early arthritis of the hip. These procedures enable athletes to get back to their sport, allow workers to return to work, and may prevent or delay the need for joint replacement.

Who will benefit from hip arthroscopy?

Fortunately, many people with hip symptoms may be candidates for hip arthroscopy. Following a combination of physical and diagnostic exams, patients are deemed suitable for hip arthroscopy on a case-by-case basis. Patients who respond best to hip arthroscopy are active individuals with hip pain that is attributable to a specific lesion within the hip joint. Patients who have developed significant cartilage loss in the joint (ie arthritis) may be better suited to have a more extensive operation, which may include a hip replacement.

How successful is hip arthroscopy?

Studies have shown that 85-90% of hip arthroscopy patients return to sports and other physical activities at the level they were at before their onset of hip pain and disability. The majority of patients clearly get better, but it is not yet clear to what extent the procedure stops the course of arthritis.

Dr. Lonnie DavisWhy is arthroscopy being done more frequently now?

Hip injuries, once thought to be a problem only in the elderly, are extremely common in people of all ages. Young patients with hip injuries may go undiagnosed for years, while others may be misdiagnosed with problems such as groin strains, sciatica, bursitis or hernias. In cases where patients are correctly diagnosed with hip pain, many have been told they have “early arthritis” or they may eventually need a hip replacement.

 

What are the common symptoms associated with hip joint injuries?

Many people first realize a pain in the front of their hip (groin) after prolonged sitting, walking or getting out of a car. Walking uphill is also commonly difficult. The pain may be a constant dull ache or a catching and/or sharp, popping sensation. Pain is also frequently felt along the side of the thigh and in the buttock.

Minimally Invasive Hip SurgeryHow do I know if I need surgery?

As with most orthopaedic conditions, there are nonsurgical and surgical treatment options. Many patients with hip injuries will respond to conservative treatment options including activity modifications, medication and physical therapy. If these measures fail, surgery is often indicated. Additionally, by utilizing specific diagnostic tools, including specialized imaging studies and joint injections, surgeons are able more precisely determine which patients are candidates for hip arthroscopy.

What happens during a hip arthroscopy?

Arthroscopic surgery of the hip, “hip scope”, is a minimally invasive procedure performed through tiny incisions, using a small, pencil-sized camera inside the joint to visualize the damaged structures. A variety of instruments repair torn tissue, remove bone spurs, re-shape abnormal bones and treat injured cartilage. The procedure is normally done as an “outpatient” surgery, which means the patient has surgery in the morning and can go home that same day.

Common arthroscopic procedures include:

hip arthroscopy

 

  • Acetabular labral tear (Learn more)
  • Femoro-acetabular impingement (Learn more)
  • Arthroscopic Microfracture
  • Removal of loose bodies

 

 

What is the recovery time associated with hip arthroscopy?

Hip arthroscopy is an outpatient procedure which allows patients to return home the same day. Patients begin physical therapy the day after surgery, focusing on reducing swelling and starting controlled strength and flexibility exercises for the hip. Most patients will take pain medicine for only a few days after surgery, and will return to normal walking within two weeks. Athletes may return to competitive sports in approximately three months. Residual soreness or pain following physical activity may continue for 3-6 months after surgery.

What complications are associated with hip arthroscopy?

As with all surgical procedures, there remains a small likelihood of complications associated with hip arthroscopy. Some of the risks are related to the use of traction. Traction is required to distract and open up the hip joint to allow for the insertion of surgical instruments. This can lead to post-surgery muscle and soft tissue pain, particularly around the hip and thigh. Temporary numbness in the groin and/or thigh can also result from prolonged traction. Complications have been reported to occur in up to 5% of patients and are most often related to temporary numbness/altered feeling in the groin and genitalia. This is due to a combination of distraction of the hip joint and pressure on the nerves in the groin at the time of surgery. In the majority of patients the numbness recovers fully, usually within a few days. Additionally, there are certain neurovascular structures around the hip joint that can be injured during surgery, as well as a chance of a poor reaction to the anesthesia or infection.

Conclusion

Hip arthroscopy is indicated when conservative measures fail to relieve symptoms related injury to the structures within and about the hip joint. Advances have made hip arthroscopy a safe and effective alternative to open surgery of the hip, a tremendous advantage in treating early hip conditions that ultimately can advance to end-stage arthritis. CFOSM surgeons have the special training and experience to perform hip arthroscopy skillfully and with successful outcome.