Hip Arthroscopy

Arthroscopy is a surgical procedure that gives doctors a clear view of the inside of a joint. This helps them diagnose and treat joint problems.

During hip arthroscopy, Dr. Wilson inserts a small camera, called an arthroscope, into your hip joint. The camera displays pictures on a television screen, and he uses these images to guide miniature surgical instruments.

Hip arthroscopy has been performed for many years, but is not as common as knee or shoulder arthroscopy.  In fact, Dr. Wilson is the only surgeon in the area to offer this novel treatment.

When Hip Arthroscopy Is Recommended

Dr. Wilson may recommend hip arthroscopy if you have a painful condition that does not respond to nonsurgical treatment. Nonsurgical treatment includes rest, physical therapy, and medications or injections that can reduce inflammation. Inflammation is one of your body's normal reactions to injury or disease. In an injured or diseased hip joint, inflammation causes swelling, pain, and stiffness.

Hip arthroscopy may relieve painful symptoms of many problems that damage the labrum, articular cartilage, or other soft tissues surrounding the joint. Although this damage can result from an injury, other orthopaedic conditions can lead to these problems, such as:

  • Femoroacetabular impingement (FAI) is a disorder where bone spurs (bone overgrowth) around the socket or the femoral head cause damage.
  • Dysplasia is a condition where the socket is abnormally shallow and makes the labrum more susceptible to tearing.
  • Snapping hip syndromes cause a tendon to rub across the outside of the joint. This type of snapping or popping is often harmless and does not need treatment. In some cases, however, the tendon is damaged from the repeated rubbing.
  • Synovitis causes the tissues that surround the joint to become inflamed.
  • Loose bodies are fragments of bone or cartilage that become loose and move around within the joint.
  • Hip joint infection

Planning for Surgery

Be sure to inform Dr. Wilson of any medications or supplements that you take. He may tell you which medications to stop and which to take prior to surgery.

If you are generally healthy, your hip arthroscopy will most likely be performed as an outpatient. This means you will not need to stay overnight at the hospital.

East Alabama Medical Center will contact you ahead of time to provide specific details of your procedure. Make sure to follow the instructions on when to arrive and especially on when to stop eating or drinking prior to your procedure.

Before the operation, you will also be evaluated by a member of the anesthesia team. Hip arthroscopy is most commonly performed under general anesthesia, where you go to sleep for the operation. Regional anesthesia, such as spinal or epidural, can also be used. With regional anesthesia, you are awake but your body is numb from the waist down. Your anesthesiologist will talk to you about which method is best for you.

Surgical Procedure

At the start of the procedure after you have been put to sleep, your leg will be put in traction. This means that your hip will be pulled away from the socket enough for Dr. Wilson to insert instruments, see the entire joint, and perform the treatments needed.

After traction is applied, he will make a small puncture in your hip (about the size of a buttonhole) for the arthroscope. Through the arthroscope, he can view the inside of your hip and identify damage.

Dr. Wilson will insert other instruments through separate incisions to treat the problem. A range of procedures can be done, depending on your needs. For example, he can:

  • Smooth off torn cartilage or repair it
  • Trim bone spurs caused by FAI
  • Remove inflamed synovial tissue

The length of the procedure will depend on what Dr. Wilson finds and the amount of work to be done.

Complications

Complications from hip arthroscopy are uncommon. Any surgery in the hip joint carries a small risk of injury to the surrounding nerves or vessels, or the joint itself. The traction needed for the procedure can stretch nerves and cause numbness, but this is usually temporary.

There are also small risks of infection, as well as blood clots forming in the legs (deep vein thrombosis).

Recovery

After surgery, you will stay in the recovery room for 1 to 2 hours before being discharged home. You will need someone to drive you home and stay with you at least the first night. You can also expect to be on crutches, or a walker, for some period of time.

Rehabilitation

Dr. Wilson will develop a rehabilitation plan based on the surgical procedures you required. In some cases, crutches are necessary, but only until any limping has stopped. If you required a more extensive procedure, however, you may need crutches for 1 to 2 months.

In most cases, physical therapy is necessary to achieve the best recovery. Specific exercises to restore your strength and mobility are important. Your therapist can also guide you with additional do's and dont's during your rehabilitation.

Long-Term Outcomes

Many people return to full, unrestricted activities after arthroscopy. Your recovery will depend on the type of damage that was present in your hip.

For some people, lifestyle changes are necessary to protect the joint. An example might be changing from high impact exercise (such as running) to lower impact activities (such as swimming or cycling). These are decisions you will make with the guidance of Dr. Wilson.

Sometimes, the damage can be severe enough that it cannot be completely reversed and the procedure may not be successful.