Hip arthroscopy, also referred to as keyhole surgery or minimally invasive surgery, is performed through very small incisions to evaluate and treat a variety of hip conditions. Arthroscopy is a surgical procedure in which an arthroscope is inserted into a joint. Arthroscopy is a term that comes from two Greek words, arthro-, meaning joint, and -skopein, meaning to examine. Arthroscope is a pencil-sized instrument that has a small lens and lighting system at its one end. Arthroscope magnifies and illuminates the structures inside the body with the light that is transmitted through fibre optics. It is attached to a television camera and the internal structures are seen on the television monitor.
Hip arthroscopy may be indicated in following conditions:
- Debridement of loose bodies: Bone chips or torn cartilage debris cause hip pain and decreased range of motion and can be removed with hip arthroscopy.
- Removal of adhesions: Adhesions are areas of built up scar tissue that can limit movement and cause pain.
- Repair of torn labrum: The labrum lines the outer edge of the “socket” or acetabulum to ensure a good fit. Tears can occur in the labrum causing hip pain.
- Removal of bone spurs: Extra bone growth caused by injury or arthritis that damages the ends of the bones cause pain and limited joint mobility.
- Partial Synovectomy: Removal of portions of the inflamed synovium (joint lining) in patients with inflammatory arthritis can help to decrease the patient’s pain. However, a complete synovectomy requires an open, larger hip incision.
- Debridement of joint surfaces: Conditions such as arthritis can cause the breakdown of tissue or bone in the joint.
- Repair after Trauma: Repair of fractures or torn ligaments caused by trauma.
- Evaluation and diagnosis: Patients with unexplained pain, swelling, stiffness and instability in the hip that is unresponsive to conservative treatment may undergo hip arthroscopy for evaluation and diagnosis of their condition.
Hip arthroscopy is performed under regional or general anesthesia depending on you and your surgeon’s preference. Your surgeon will make 2 or 3 small incisions about 1/4 inches in length around the hip joint. Through one of the incisions an arthroscope is inserted. Along with it, a sterile solution is pumped into the joint to expand the joint area and create room for the surgeon to work.
The larger image on the television monitor allows the surgeon to visualize the joint directly to determine the extent of damage so that it can be surgically treated. Surgical instruments will be inserted through other tiny incisions to treat the problem. After the surgery, the incisions are closed and covered with a bandage.
The advantages of hip arthroscopy over the traditional open hip surgery include:
- Smaller incisions
- Minimal trauma to surrounding ligaments, muscles, and tissues
- Less pain
- Faster recovery
- Lower infection rate
- Less scarring
- Earlier mobilization
- Shorter hospital stay
Risks and Complications
As with any surgery, there are potential risks and complications involved. It is very important that you are informed of these risks before you decide to proceed with hip arthroscopy surgery. Possible risks and complications include:
- Infection at the surgical incision site or in the joint space
- Nerve damage which may cause numbness, tingling, pain, and weakness
- Excess bleeding into the joint, a condition called hemarthrosis
- Blood clots may form inside the deep veins of the legs which can travel to the lungs (pulmonary embolism).
Your doctor may advise you to take certain precautions to promote faster recovery and prevent further complications. These include:
- Taking pain medications as prescribed.
- Use of crutches to prevent or limit bearing weight on the operated hip
- Physical therapy exercises should be performed to restore normal hip function and improve flexibility and strength
- Eating a healthy diet and avoiding smoking will help in faster healing and recovery
- Avoid activity which involves lifting heavy things or strenuous exercises for first few weeks after surgery