Hip Arthroscopy: Uses, Side Effects, Procedure, Results

What to expect when undergoing a hip arthroscopy

Hip arthroscopy
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Arthroscopic hip surgery is performedHip 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

Uses of Hip Arthroscopy

Not every condition that causes hip pain is treated effectively with an arthroscopic hip surgery, but many can be. These are some of the conditions commonly treated with arthroscopic hip surgery:

  • 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.

Side Effects

Most arthroscopic hip surgery proceeds without significant complications. The vast majority of patients recover from this surgery uneventfully. That is not to say that everyone has complete resolution of their hip joint discomfort, but only a small number of people experience significant complications from the surgical treatment. The rate of significant complication following hip arthroscopy has been found to be under 10%.

Significant complications are those that either worsen the overall degree of symptoms, or require some type of medical intervention for treatment. The most common complications of arthroscopic hip surgery or injuries to nerves, cartilage, or the labrum as a result of the surgical intervention. Nerve irritation can occur in about 20% of people undergoing arthroscopic hip surgery, but this problem typically is minor, and resolves with time. The most common type of nerve irritation is to the lateral femoral cutaneous nerve, a nerve that supplies sensation over the front and outside of the thigh. People who experience irritation of the lateral femoral cutaneous nerve may notice an area of tingling or numbness over the front or outside of the thigh. This typically resolves spontaneously within 6 months and often goes unnoticed. It is not considered a serious complication because it does not affect function of the extremity.

Injury to the cartilage or labrum occurs in about 3% of people undergoing hip arthroscopy. Instruments used during the surgical procedure can cause damage to the structures. Sometimes, this damage can lead to progression of hip joint pain, and worsening of arthritis in the joint.

Less common complications of hip arthroscopy include blood clot and pulmonary embolism, infection, pudendal nerve injury, and heterotopic ossification. The chance of any 1 of these problems occurring is less than 1%.

It is important to follow your surgeon's postsurgical instructions to help prevent complications from occurring. In addition, if you notice the following symptoms, you should let your surgeon know immediately:

  • Fever, chills, sweats (possible infection)
  • Numbness or tingling in the extremity or in your groin (nerve injury)
  • Worsening swelling or discomfort in your calf (possible blood clot)
  • Difficulty breathing or shortness of breath (pulmonary embolism)
  • Worsening symptoms of pain or difficulty walking (cartilage damage)

These are not the only signs of problems, but most of the serious complications that occur following hip arthroscopy will be accompanied by 1 of these signs. If you are experiencing 1 of these symptoms, let your doctor know. It is possible that your symptoms might not be associated with a complication, but it certainly better to have any unusual symptoms evaluated sooner rather than later. Sometimes when a complication is detected early, it is much more easily managed than when it is not detected until it is a more serious problem.

Procedure

As an outpatient surgical procedure. The actual surgical procedure takes anywhere from about an hour to 2 hours, depending on the extent of surgery that is performed. It is performed under either general or spinal anesthesia, although both surgical procedures are done under general anesthesia.

The number of incisions used during the surgical procedure going very on the specific procedure that is necessary. Anywhere from 2-4 portals are typically necessary in order to perform most arthroscopic hip surgery. While the incisions are small, the surgical trauma to the joint is more significant. For that reason, people who undergo arthroscopic hip surgery will typically use crutches for at least a few weeks following surgery. During some type of surgical repairs, a longer period of time is necessary to protect weight on the joint.

Results

Results of arthroscopic hip surgery depend entirely on the specific surgical procedure. For the most part, patients are satisfied with the results of arthroscopic hip surgery. Complications are unusual, and the most common complication is ongoing symptoms of discomfort. The most common reason why people experience complications is that the indications for performing the surgical procedure were stretched. This means the patient's are having arthroscopic hip surgery even when they are not ideal candidates for this surgical procedure. This may mean that they have a little too much arthritis in the joint, are less inclined to do the postoperative rehabilitation, or have other characteristics that make them less than ideal candidates for surgery. Because of that, some of these people undergoing arthroscopic hip surgery may not do as well as they had hoped. People who are good candidates for arthroscopic hip surgery generally have good results.

A Word From Verywell

Arthroscopic hip surgery is becoming a much more common treatment used to manage a variety of conditions that cause hip pain. While not every condition can be effectively managed with an arthroscopic surgery, people who undergo hip arthroscopy for the right reason generally have good results. While complications from arthroscopic surgery are rare, they can occur. Some of these complications can be serious. Before undergoing hip arthroscopy, make sure you have a good understanding of your likelihood of recovery, and the postoperative rehabilitation will be necessary following your surgical procedure.

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