Hip Arthroscopy

Hip Arthroscopy

Anatomy

The joint is surrounded by bands of tissue called ligaments. They form a capsule that holds the joint together. The undersurface of the capsule is lined by a thin membrane called the synovium. It produces synovial fluid that lubricates the hip joint.

The hip is a ball-and-socket joint. The socket is formed by the acetabulum, which is part of the large pelvis bone. The ball is the femoral head, which is the upper end of the femur (thighbone).

A slippery tissue called articular cartilage covers the surface of the ball and the socket. It creates a smooth, frictionless surface that helps the bones glide easily across each other. The acetabulum is ringed by strong fibrocartilage called the labrum. The labrum forms a gasket around the socket.

Uses

Your doctor may recommend hip arthroscopy if you have a painful condition that does not respond to nonsurgical treatment. Nonsurgical treatment includes rest, physical therapy, and medications or injections that can reduce inflammation. Inflammation is one of your body’s normal reactions to injury or disease. In an injured or diseased hip joint, inflammation causes swelling, pain, and stiffness.

Hip arthroscopy may relieve painful symptoms of many problems that damage the labrum, articular cartilage, or other soft tissues surrounding the joint. Although this damage can result from an injury, other orthopaedic conditions can lead to these problems, such as:

  • Femoroacetabular impingement (FAI) is a disorder where bone spurs (bone overgrowth) around the socket or the femoral head cause damage.
  • Dysplasia is a condition where the socket is abnormally shallow and makes the labrum more susceptible to tearing.
  • Snapping hip syndromes cause a tendon to rub across the outside of the joint. This type of snapping or popping is often harmless and does not need treatment. In some cases, however, the tendon is damaged from the repeated rubbing.
  • Synovitis causes the tissues that surround the joint to become inflamed.
  • Loose bodies are fragments of bone or cartilage that become loose and move around within the joint.
  • Hip joint infection

Procedure

Hip arthroscopy has been performed for many years, but is not as common as knee or shoulder arthroscopy.

Arthroscopy is a surgical procedure that gives doctors a clear view of the inside of a joint. This helps them diagnose and treat joint problems.

During hip arthroscopy, your surgeon inserts a small camera, called an arthroscope, into your hip joint. The camera displays pictures on a television screen, and your surgeon uses these images to guide miniature surgical instruments.

At the start of the procedure, your leg will be put in traction. This means that your hip will be pulled away from the socket enough for your surgeon to insert instruments, see the entire joint, and perform the treatments needed.The length of the procedure will depend on what your surgeon finds and the amount of work to be done.

After traction is applied, your surgeon will make a small puncture in your hip (about the size of a buttonhole) for the arthroscope. Through the arthroscope, he or she can view the inside of your hip and identify damage.

Your surgeon will insert other instruments through separate incisions to treat the problem. A range of procedures can be done, depending on your needs. For example, your surgeon can:

  • Smooth off torn cartilage or repair it
  • Trim bone spurs caused by FAI
  • Remove inflamed synovial tissue