Hip arthroscopy is a surgical procedure that allows surgeons to view the hip joint without making a large cut through the skin and other soft tissues. Arthroscopy is used to diagnose and treat a wide range of hip problems.
During hip arthroscopy, we insert a small camera, called an arthroscope, into your hip joint. The camera displays pictures on a video monitor, and we use these images to guide miniature surgical instruments.
Because the arthroscope and surgical instruments are thin, we can use very small incisions, rather than the larger incision needed for open surgery. This results in less pain for patients, less joint stiffness, and often shortens the time it takes to recover and return to favorite activities.
When is a hip arthroscopy recommended
We may recommend hip arthroscopy if you have a painful condition that does not respond to non-surgical treatment. This includes rest, physical therapy, and medications or injections that can reduce inflammation.
Hip arthroscopy may relieve painful symptoms of the joint caused by a range of orthopaedic conditions, including:
- Femoroacetabular impingement (FAI)
- Bone spurs
- Snapping hip syndrome
- Loose fragments of bone or cartilage
- Hip joint infection
Hip arthroscopy may relieve painful symptoms of the joint caused by a range of orthopaedic conditions
Planning for Surgery
Hip arthroscopy is most commonly performed under general anesthesia – where you go to sleep for the operation. Regional anesthesia, such as spinal or epidural, can also be used. With regional anesthesia, you are awake but your body is numb from the waist down.
Complications from hip arthroscopy are uncommon. Any surgery in the hip joint carries a small risk of injury to the surrounding nerves or blood vessels, or the joint itself. The traction needed for the procedure can stretch nerves and cause numbness, but this is usually temporary.
There are also small risks of infection, as well as blood clots forming in the legs (deep vein thrombosis).
Dr Al-Khateeb will make a small puncture in your hip (the size of a buttonhole) for the arthroscope. Through the arthroscope, we can view the inside of your hip and identify the damage.
Fluid flows through the arthroscope to keep the view clear and control any bleeding. Images from the arthroscope are projected on the video screen showing the inside of your hip and any problems. We will evaluate the joint before beginning any specific treatments.
Once the problem is clearly identified, we will insert other small instruments through separate incisions to repair it. A range of procedures can be done, depending on your needs. For example,
- Smooth off torn cartilage or repair it
- Trim bone spurs caused by FAI
- Remove inflamed synovial tissue
The length of the procedure will depend on what we find and the amount of work to be done.
At the end of surgery, the arthroscopy incisions are usually stitched or covered with skin tapes. An absorbent dressing is applied to the hip.
After surgery, you will stay in the recovery room for 1 to 2 hours before being discharged home. You will need someone to drive you home and stay with you at least the first night. You can also expect to be on crutches, or a walker, for some period of time.
After surgery, you will feel some pain. This is a natural part of the healing process.
Medications are often prescribed for short-term pain relief after surgery. Many types of medicines are available to help manage pain, including opioids, non-steroidal anti-inflammatory drugs (NSAIDs), and local anesthetics. We may use a combination of these medications to improve pain relief, as well as minimize the need for opioids.
In addition to medicines for pain relief, we may also recommend medication such as aspirin to lessen the risk of blood clots.
Crutches may be necessary after your procedure. In some cases, they are needed only until any limping has stopped. If you required a more extensive procedure, however, you may need crutches for 1 to 2 months.
We will develop a rehabilitation plan based on the surgical procedures you required. In most cases, physical therapy is necessary to achieve the best recovery. Specific exercises to restore your strength and mobility are important. Your physiotherapist can also guide you with additional do’s and dont’s during your rehabilitation.
Many people return to full, unrestricted activities after arthroscopy. Your recovery will depend on the type of damage that was present in your hip.
For some people, lifestyle changes are necessary to protect the joint. An example might be changing from high impact exercise (such as running) to lower impact activities (such as swimming or cycling). These are decisions you will make with the guidance of Dr Al-Khateeb.
Sometimes, the damage can be severe enough that it cannot be completely reversed and the procedure may not be successful.