Hip arthroscopy is a minimally invasive surgical procedure in which a small fibre-optic camera (arthroscope) and special surgical instruments are inserted into the hip joint through small incisions. The camera is attached to a monitoring screen that allows your surgeon to view and access any damage within the hip joint and to perform repairs as necessary.
The hip is a ball and socket joint that connects the thigh bone (femur) to the hip socket in the pelvis (acetabulum) to allow movement of the legs. The hip joint consists of the thigh bone and pelvis that are both covered in a smooth tissue called cartilage and separated by fluid to cushion the joint and allow smooth movement. The bones are held together by ligaments, tendons and muscles.
When parts of the joint become diseased or damaged, it leads to pain and stiffness resulting in a loss of movement that affects the ability to undertake usual daily activities. A hip arthroscopy may be performed to diagnose and treat the following hip conditions:
- Removal of bone chips or torn cartilage within the hip joint that cause pain and decreased movement.
- Removal of bone spurs (extra bone growth) on the ends of the bones caused by injury or arthritis that leads to pain and decreased mobility
- Removal of built up scar tissue (adhesions) within the hip joint from an injury that causes pain and limits movement.
- Repair torn labrum. The labrum is a ring of fibrous cartilage that sits along the rim of the hip socket (acetabulum) to ensure the top of the thighbone (femoral head) is held securely in the socket. Tears to the labrum can result in pain, locking or clicking of your hip joint, and reduced movement.
- Repair of fractures or ligament damage after trauma.
- Partial removal of inflamed membrane (synovium). The synovial membrane forms a cushion between the top of the thighbone (femur) and the hip socket (acetabulum) and allows for smooth movement.
- Treatment of Femoroacetabular impingement.
- Evaluate and diagnose unexplained pain, swelling, stiffness and instability in the hip joint.
If you are experiencing ongoing pain or stiffness in or around your hip joint that affects your mobility, you should consult your doctor. Your doctor will assess the history of your pain and other symptoms as well as your family medical history. A physical examination will also be performed to assess your range of hip movement. Your doctor may also refer you for an x-ray of your hip joint and on occasions an MRI and/or CT scan is also required.
For most hip conditions, surgery is only recommended once non-surgical options are no longer effective in managing your symptoms and your symptoms are impacting your ability to undertake usual daily activities.
The benefits of arthroscopy over invasive hip surgery include:
- Smaller incisions
- Minimal damage to tissues surrounding the hip joint
- Earlier mobilisation
- Shorter hospital stay
- Less pain following the procedure
- Faster recovery time
As with any surgery there are potential risks to undergoing an arthroscopy.
General complications of any surgery include:
- Allergic reactions to medications
- Blood loss requiring transfusion
- Heart attack, strokes, kidney failure, pneumonia, bladder infections
- Complication from nerve blocks such as infection or nerve damage
The complications specific to arthroscopy include:
- Nerve damage
- Deep vein thrombosis (blood clot)
- Haemarthrosis (excessive bleeding into the joint after the procedure that may require additional surgery)
- Failure to relieve pain
Preparing for your arthroscopy
Preparation begins prior to your admission to hospital. Arrangements should be made in advance to prepare for your recovery including:
- Ensuring your home is free from tripping hazards,
- Ensuring regularly used items are easily accessible,
- Arranging to have someone at home with you or to check in on you when you are discharged.
Your surgeon will discuss your surgery and what to expect. Your surgeon will refer you to have routine blood tests and other investigations prior to your surgery. Remember to bring your x-rays with you to hospital. You will be given instructions regarding your medications and it is important you follow these. These may include:
- Cease blood thinning medication such as aspirin and anti-inflammatory medications up to 7 days prior to your surgery
- Cease naturopathic or herbal medications 7 days prior to your surgery
Certain lifestyle risk factors can slow your healing following your surgery. In preparation for your recovery aim to:
- Eat healthy
- Quit smoking
- Reduce alcohol intake
- Reduce weight if overweight (follow medical advice on safe exercise prior to and following surgery)
Arthroscopy can be a day-only procedure or require an overnight hospital stay. You will require someone to drive you home.
Prior to discharge, you will be given information on post-operative wound care and instructions regarding activity and exercises. Your surgeon will prescribe you pain medication for you to manage your pain at home.
On discharge, you will be given an information pack which will include an appointment to see your surgeon as an outpatient and physiotherapy instructions.