Hip arthroscopy

Answer 1

Definition

Hip arthroscopy is surgery that is done by making small cuts around your hip and looking inside using a tiny camera. Other medical instruments may also be placed inside to fix your hip.

Alternative Names

Arthroscopy - hip; Hip impingement syndrome - arthroscopy; Femero-acetabular impingement - arthroscopy; FAI - arthroscopy; Labrum - arthroscopy

DescriptionDuring arthroscopy of the hip, the surgeon uses a tiny camera to see inside your hip.

• An arthroscope is made up of a tiny tube, a lens, and a light source. The surgeon will look inside your hip joint for damage or disease. Only a small surgical cut is made.
• Other medical instruments may also be inserted through one or two other small surgical cuts. This allows the surgeon to treat or fix certain problems, if needed.
• Using these tools, your surgeon will remove extra pieces of bone that are loose in your hip joint, or fix cartilage or other tissues that may be damaged.

Spinal or epiduralorgeneral anesthesiawill most likely be used. You may also receive medicine to help you relax. Indications

The most common reasons for hip arthroscopy are to:

• Remove small pieces of bone or cartilage that may be floating around inside your hip joint and causing pain
• Repair a torn labrum (a tear in the cartilage that is attached to the rim of your hip socket bone)

Less common reasons for hip arthroscopy are:

• Hip impingement syndrome (also called femero-acetabular impingement, or FAI), when no other treatment has helped.
• Hip pain that does not go away and your doctor suspects a problem that hip arthroscopy can fix. Most of the time, your doctor will first inject numbing medicine into the hip to see if the pain goes away.

If you do not have one of these problems, hip arthroscopy will probably not be useful for treating your hip Arthritis. Risks

The risks for any anesthesia are:

• Allergic reactions to medicines
• Breathing problems

The risks for any surgery are:

• Bleeding
• Infection

Other risks from this surgery include:

• Bleeding into the hip joint
• Damage to the cartilage or ligaments in the hip
• Blood clot in the leg
• Injury to a blood vessel or nerve
• Infection in the hip joint
• Hip stiffness

Expectations after surgery

Whether you fully recover after hip arthroscopy depends on what type of problem was treated.

If you also have arthritis in your knee, you will still have arthritis symptoms after hip surgery.

Before You Have the Procedure

Always tell your doctor or nurse what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription.

During the 2 weeks before your surgery:

• You may be asked to stop taking drugs that make it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), naproxen (Naprosyn, Aleve), and other drugs.
• Ask your doctor which drugs you should still take on the day of your surgery.
• Tell your doctor if you have been drinking a lot of alcohol, more than 1 or 2 drinks a day.
• If you smoke, try to stop. Ask your doctor for help. Smoking can slow down wound and bone healing.

On the day of your surgery:

• You will usually be asked not to drink or eat anything for 6 to 12 hours before the procedure.
• Take the drugs your doctor told you to take with a small sip of water.
• Your doctor or nurse will tell you when to arrive at the hospital.

Convalescence

After surgery, you will be asked to use crutches for 2 - 6 weeks.

• During the first week, you should not place any weight on the side that had surgery.
• After that, you will slowly be allowed to place more and more weight on the hip that had surgery.

You should be able to return to work within 1 to 2 weeks if you can sit most of the time.

You will be referred to physical therapy to begin an exercise program. References

Miller MD, Hart J. Surgical principles. In: DeLee JC, Drez D Jr, Miller MD, eds. DeLee and Drez's Orthopaedic Sports Medicine. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2009:chap 2.

Reviewed By

Review Date: 08/12/2011

C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, and Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.