Should You Get a Hip Arthroscopy?

Hip arthroscopy
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Hip arthroscopy is performed through small incisions using a camera to visualize the inside of a joint. Through several small incisions (about 1 centimeter each) your surgeon will insert a camera into one incision, and small instruments through the other incisions.

Three Things to Know

Hip arthroscopy has limited potential benefit as we get older. Numerous studies have shown that hip arthroscopy is a treatment to be used in younger (under the age of 40) populations. While there may be people older than that who find this a useful treatment, the prognosis is much less successful after the age of 40.

Long-term benefits of a hip arthroscopy are not known. A hip arthroscopy is a great treatment for current symptoms, and there are some who hope this will also lead to long-term benefit. However, this is simply not known. For example, people with bone spurs that form around the hip joint are thought to have an early form of hip arthritis. Removing these bone spurs may not have any impact on the development of hip arthritis later in life.

Not every hip joint problem can be treated with arthroscopic surgery. Hip arthroscopy is a great treatment, but not for every hip problem. While there are a number of conditions that can be helped by an arthroscopic procedure, there are others that may not be helped. Furthermore, just because a labral tear is seen on an MRI, it may not be the source of pain. Working with an experienced hip arthroscopy surgeon is critical to ensuring you find success with treatment.

The nice part about hip arthroscopy is that it is much less invasive than traditional hip surgery. This means:

  • Early rehab
  • Accelerated rehab course
  • Outpatient procedure
  • Smaller incisions
  • Early return to sports

Conditions Treated With Hip Arthroscopy

  • Labral Tear: The labrum of the hip is a cuff of thick tissue that surround the hip socket. The labrum helps to support the hip joint. When a labral tear of the hip occurs, a piece of this tissue can become pinched in the joint causing pain and catching sensations.
  • Loose Bodies: Loose bodies are pieces of cartilage that form within the joint. They look like small marbles floating within the joint space. These loose bodies can become caught within the hip during movements.
  • Snapping Hip Syndrome: Snapping hip syndrome has several causes, some of which can be treated with hip arthroscopy. If something is catching within the hip joint, hip arthroscopy can be used to relieve this snapping. Also, hip arthroscopy can be used to perform a psoas tendon release in cases of an internal snapping hip syndrome.
  • Cartilage Damage: In patients with focal cartilage damage, meaning not widespread arthritis, hip arthroscopy may be helpful. These patients may sustain an injury causing a piece of cartilage to break away from the surface of the bone. These patients may benefit from the removal of that piece of cartilage.
  • Early Arthritis: This is a controversial topic, as patients who have arthritis pain generally will not benefit from a hip arthroscopy. The patients who tend to benefit have a specific finding of impingement (pinching) within the hip joint, and may benefit from the removal of the bone spurs causing this impingement. This is only possible in the very early stages of arthritis, and even then may not offer relief of symptoms.

Possible Complications

The most concerning complications of hip arthroscopy have to do with several important nerves and blood vessels that surround the joint. Nerve injury is uncommon, but can be a significant problem. The most commonly affected nerves include the sciatic nerve, the lateral femoral cutaneous nerve (sensation to the thigh), and the pudendal nerve. Injury to any of the nerves can cause pain and other problems.

Other possible complications from hip arthroscopy include potential injury to normal structures, infection, and continued pain after the surgery. The rate of these complications is low, but patients need to understand the potential prior to undergoing a hip arthroscopy.

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View Article Sources
  • McCarthy, JC "Hip Arthroscopy: Applications and Technique" J. Am. Acad. Ortho. Surg., May 1995; 3: 115 - 122.