What is Hip Arthroscopy?
Arthroscopy is key-hole surgery using a pencil sized fibre-optic camera. It allows safe access into the joint so that the surgeon can accurately assess damage to the joint and perform corrective procedures where required. Previously, accessing the hip joint required extensive open procedures with large incisions. Hip arthroscopy is a minimally invasive procedure which allows rapid post-operative recovery. It is useful in the treatment of selected hip disorders.
How can hip arthroscopy help?
Hip arthroscopy can used to treat the symptoms of pain or catching associated with early damage to the hip joint. It can also be used to treat hip impingement syndrome. It is useful for the accurate diagnosis of hip pathology and the assessment of suitability for other joint preservation techniques. It is often a first step in surgical treatment of hip problems.
What sort of anaesthetic is used?
A general anaesthetic is usually given for hip arthroscopy to ensure the muscles surrounding the joint are adequately relaxed to conduct the procedure.
What does the procedure involve?
Once asleep, the foot is placed into a stirrup and gentle traction is applied to separate the gap between the ball and socket of the hip joint. Usually two incisions, approximately 5mm in length, are made around the hip. This allows the camera and surgical instruments into the joint. Hip arthroscopy usually takes between 45 minutes and 2 hours, depending on the complexity of the operation.
What should I expect immediately after the arthroscopy?
Most patients experience only mild discomfort after a hip arthroscopy. There will be a bulky dressing over the wounds. This dressing can become damp with the irrigation fluid that is used during the procedure. It is normal for the fluid to have a faint red tinge. Small amounts may continue to drain for 24-36 hours. Most patients go home the next day.
How long will it take to recover?
Most patients can weight bear as tolerated immediately after the surgery. You will be informed if this is not the case. Crutches may be used for comfort where necessary and are only usually required for 2-3 days. It is advisable not to over exert too quickly after the operation as this can increase discomfort and swelling. Normal activities can be gradually reintroduced within comfort levels. Most patients are able to drive a car the following day. People with desk jobs may return to work as early as 1-2 weeks after the arthroscopy, while people in heavy manual employment may require 6 weeks off work. Sport can often be reintroduced from 4-6 weeks. 80% of high level and elite athletes return to match fitness by 16 weeks. A small number of patients may have ongoing mild discomfort for up to 3-4 months after the procedure, depending on the degree of joint damage present at arthroscopy.
Is physiotherapy required after arthroscopy?
Regular physiotherapy is essential. It assists in recovery of joint function and muscular control during the recovery period. You will be provided with a recommended rehabilitation program to take to your physiotherapist. Hydrotherapy may be started after your wounds have been assessed. This will be discussed at the first post-operative clinic review.
What are the risks?
Hip arthroscopy is a very safe procedure. The most common side effects are discomfort around the hip area and slight bruising. Numbness around the foot or groin is seen in about 5% of cases. This is caused by the traction placed on the hip during the procedure. It is usually self limiting, lasting up to a few days. Serious complications such as infection, bone fracture or permanent nerve injury are extremely rare.