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Dr Saleem Hussenbocus - Orthopaedics SA

Hip Arthroscopy

Hip arthroscopy is a minimally-invasive surgical procedure in which a small camera is inserted through an incision in the hip. The camera, which displays an image of the inside of the hip joint on a video monitor, is used by a surgeon to help diagnose some hip conditions and guide surgical procedures. The small size of the arthroscope, and the surgical instruments used, allow the surgeon to perform the procedure through several small incisions.

Although it is less frequently performed than shoulder or knee arthroscopy, hip arthroscopy has been regularly performed for many years. It is performed by orthopaedic surgeons who have undergone specialist training in hip arthroscopy.

Hip arthroscopy is used to evaluate and treat a variety of hip problems, including hip dysplasia, labral tears, femoro-acetabular impingement, and osteoarthritis of the hip. Hip arthroscopy may also be performed to remove bone spurs or fragments of cartilage from inside the hip joint.

Because they are performed through very small incisions, hip arthroscopy procedures produce less scarring and involve less disruption of the surrounding tissue than traditional open hip surgery. You may experience less pain and a quicker recovery, when compared to an open surgery. However, this can vary between patients and what is done.

In most cases, hip arthroscopy and open hip surgery are equally effective at providing lasting treatment. At your consultation, your surgeon will thoroughly evaluate your condition and ask questions about your medical history to decide on the best option for you.

As with any surgical procedure, hip arthroscopy has certain risks. These may include:

·       Anaesthesia risks (such as allergies, heart attack, stroke, or respiratory distress)

·       Infection

·       Excessive bleeding

·       Blood clots and/or deep vein thrombosis

·       Structure or nerve damage

·       Delayed healing

·       Ongoing pain

·       Scarring

Before your hip arthroscopy, your surgeon will talk to you about the risks involved in the procedure, and any that may affect you in particular. They will give you advice on how to best manage these and minimise your risk of complications.

Hip arthroscopy usually takes place under general anaesthesia, although it can be performed under spinal or regional anaesthesia.  After you are asleep, your leg will be placed in a traction device which pulls the ball of the hip joint away from its socket, allowing the surgeon to see inside.

After the exact location of the hip joint has been determined with an x-ray, the surgeon makes an incision approximately 5mm wide in the skin. The arthroscope is inserted through this incision and used to look around inside the hip joint. More incisions are then made as necessary to accommodate the tools that will be used. Sterile saline is used to irrigate the joint.

Once the tools are in place and the surgeon has thoroughly evaluated your hip joint using the arthroscope, they will begin repairing the problem. Depending on the condition being treated, they may remove loose cartilage or bone spurs, place stitches in the labrum (a cartilage-type tissue on the edge of the hip socket), or shave sections of the hip bones.

After the hip arthroscopy is complete, each incision is closed with 1-2 stitches and a sterile dressing is positioned to cover the wound. You will be taken to a recovery room to wake up and be observed before you can be discharged. The whole procedure usually takes only 1-2 hours, and you may be able to leave the hospital on the same day.

If you are otherwise healthy, your hip arthroscopy will usually be performed as a day case procedure. Most patients are able to walk on crutches immediately after surgery with partial weight bearing. Prior to discharge, you will be given a written instruction sheet and a prescription for any medications you may require.

You may experience numbness in the leg or groin after your hip arthroscopy. This is caused by pressure placed on the nerves during traction, and usually resolves on its own after a few hours. There will usually be some tenderness and swelling in the area which will disappear within a few days.

Despite the small incisions, hip arthroscopy is still a major surgical procedure. You may need to use crutches for 4-6 weeks afterwards, and a full recovery may take 6-12 months. Most patients can resume driving about 6 weeks after a hip arthroscopy.

Overall recovery from a hip arthroscopy is dependent on a variety of factors and is unique to everyone. Before your procedure, your surgeon will talk to you about activities that will influence your recovery and provide advice to help make your recovery as smooth as possible.

Read more about hip injuries and conditions.

Or view our videos about hip surgery.




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