Hip arthroscopy is recommended to address focal issues within the hip joint such as loose bodies and frayed tissue that may be catching and causing pain. It is also sometimes used to trim excess bone that may be causing femoral acetabular impingement, and for treatment of labrum tears. Hip arthroscopy is not recommended for treatment of advanced hip osteoarthritis or hip fractures.
Arthroscopy is a technique that involves placing a camera and various tools inside a joint in order to perform surgical procedures within the joint. Hip arthroscopy is not as commonly performed as knee or shoulder arthroscopy. The first step in performing a hip arthroscopy involves placing the affected hip in a special operating table that applies traction to the hip. This helps to fix the hip in an optimal position for performing the procedure. After this, two small incisions are made around the hip joint using a scalpel. A small camera called an arthroscope is then placed through one incision, and various tools can be inserted through the other.
The camera is used to visualize the inside of the joint, which is magnified and displayed on a screen in the operating room. A special fluid is continually passed through the arthroscope to clear away blood that may be blocking the view. Various small tools are inserted through the incisions that can clean and trim the tissues within the joint, as well as grab and remove any loose bone fragments that may be causing pain.
The main advantage of arthroscopy is that is it less invasive than an open surgical procedure, which would require a larger incision and more exposure of the hip joint to the outside environment. Additionally, there is less stress placed on the joint during the procedure, lending to a faster recovery time. Despite these advantages, hip arthroscopy has limited utility because it is only useful for treatment of a small subset of hip conditions.
Recovering from hip arthroscopy is usually much faster than with other hip surgeries. It is often recommended that the patient begin walking the same day with an assistive device such as crutches. Pain medications like NSAIDs can be used to manage symptoms of pain, and blood thinners such as aspirin are sometimes recommended to reduce the post-surgical risk of developing a deep vein thrombosis.
Caring for the surgical wound is an important part of recovery from any surgery. With arthroscopy, this is easier because there are usually no or very few sutures required to close the small incisions. Changing the bandages on the surgical incisions is important in the post-operative period to protect the small incisions from infection. Additionally, physical therapy and at-home exercises may be recommended in order to regain full range of motion of the hip joint.
Potential complications of hip arthroscopy include:
- Post-surgical infection
- Deep vein thrombosis and pulmonary embolism
- Injury to the pudendal or sciatic nerves
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