Hip arthroscopy is a minimally invasive procedure used to diagnose and treat a wide range of conditions affecting the hip joint. This procedure can be used to confirm the diagnosis of various imaging procedures, such as X-rays and MRIs, as it provides a three-dimensional, real-time image of the affected area. If damage or abnormalities are detected during the arthroscopy, repairs can often be made during the same procedure.
Reasons for Hip Arthroscopy
Hip arthroscopies can be performed for a number of reasons, to definitively diagnose or repair of the following conditions:
- Joint cartilage (labral) tears
- Loose pieces of bone or cartilage, or bone spurs
- Snapping hip syndrome
Candidates for Hip Arthroscopy
Arthroscopy is considered an ideal treatment option for many conditions affecting the hip, since it offers smaller incisions, shorter recovery times and less scarring. Patients can often return home the same day as their procedure and resume their regular activities in just a few weeks, while enjoying less pain, greater range of motion and restored joint function.
While arthroscopy offers many advantages over conventional hip surgery, it is not right for all patients, especially those with conditions affecting hard-to-visualize areas. In such cases, traditional surgery may be more appropriate.
Hip Arthroscopy Procedure
During the hip arthroscopy procedure, the surgeon makes a small incision near the affected area of the hip and inserts an arthroscope, a long flexible tube with a camera and a tiny light on the end. This device displays magnified images of the inside of the hip joint on a video monitor for the surgeon to view in real time. During this diagnostic part of the procedure, the hip is examined for any signs of tearing, damage or degeneration to the ligaments, cartilage and other internal structures.
If damage is detected, it can often be repaired during the same procedure by creating a few more small incisions through which tiny surgical instruments are inserted. These instruments allow the surgeon to replace damaged cartilage, join together torn ends, remove loose bodies or realign the joint to minimize pain and inflammation. Once the repair has been performed, the tools and arthroscope are removed and the incisions are sutured closed. A dressing will be applied to the area, which will later be replaced with smaller bandages as the incisions heal.
Recovery from Hip Arthroscopy
After the hip arthroscopy procedure, patients may experience pain, swelling and bruising at the incision sites for several days. Pain medication and the application of ice are advised in order to manage this pain and reduce inflammation. Most patients will be encouraged to get up and walk around as soon as possible, but will need to use crutches or a walker for 7 to 10 days as healing takes place.
In order to restore function and strength to the hip joint, patients will need to undergo a customized physical rehabilitation program after surgery, designed to meet their individual goals. Physical rehabilitation may include weight-bearing exercises, hip mobilization techniques, flexibility exercises and other activities that target the various muscles of the region: the quadriceps, the hamstrings, the gluteals, the abductors and adductors. The length of the rehabilitation regimen varies according the patient’s specific condition and rate of healing. Most patients are able to return to full physical activity after several weeks, but other may require up to 12 weeks to fully recover.
What are the Risks of Hip Arthroscopy?
While hip arthroscopy is considered safer and more efficient than conventional hip procedures, there are still certain risks associated with any type of surgery. Some of these risks may include:
- Nerve or blood vessel damage
- Tissue damage
- Prolonged pain
- Blood clots
Patients should discuss these and other risks with the doctor before undergoing hip arthroscopy.
Snapping Hip Syndrome
Snapping hip syndrome, or “dancer’s hip” is a condition commonly affecting athletes and dancers. It involves a snapping sensation, often accompanied by a popping sound during movement. The snapping sensation occurs as a muscle or tendon in the area moves over a bony structure. While the syndrome, for many, is only an annoyance, for individuals with a very active lifestyle or occupation it may lead to pain, weakness and disability.
Most commonly, the problem occurs in a band of connective tissue that passes over large jutting bone of the thigh, the trochanter. This band is known as the iliotibial band. Two other bands can cause snapping hip syndrome: the iliopsoas, which connects to the inner upper thigh and the rectus femoris, which stretches from the inner thigh through the pelvis. Less frequently, snapping hip syndrome can be the result of torn cartilage or bone in the hip joint, known as a labral tear. Which injury is causing the problem is determined through physical examination and X-rays.
When snapping hip syndrome does not involve pain, no treatment is required. For patients who experience mild pain, home remedies, such as over-the-counter pain medications and applications of ice to the affected area, may suffice. It may also be necessary to modify activity level. If pain is severe or persistent, medical consultation is needed.
Treatment of snapping hip syndrome may include physical rehabilitation and/or corticosteroid injections. Physical therapy most often consists of exercises to strengthen and stretch muscles, especially the quadriceps, and to align the hip joint. Corticosteroid injections serve to reduce inflammation and relieve pain. In rare cases, when snapping hip syndrome does not respond to other treatments, surgical repair may be necessary.