Hip

Hip Arthroscopy

Hip arthroscopy is a minimally invasive surgical procedure that allows doctors to view and manage pathology in the hip joint. Arthroscopy is used to diagnose and treat a wide range of hip problems.

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

Because the arthroscope and surgical instruments are thin, your surgeon can use very small incisions, rather than the larger incision needed for open surgery. This results in less pain and joint stiffness for patients, and it often shortens the time it takes to recover and return to favorite activities.

Anatomy

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, robust tissue called articular cartilage covers the surfaces 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 (fills the space) around the socket, deepening the socket and improving the stability of the joint.

The joint is surrounded by bands of tissue called ligaments. They form a capsule that holds the joint together.

When Hip Arthroscopy Is Recommended

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.

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, including:

• Femoroacetabular impingement (FAI), a disorder in which extra bone develops along the acetabulum (pincer impingement) or on the femoral head (cam impingement). This bone overgrowth can damage the soft tissues of the hip during movement, particularly the articular cartilage. Sometimes bone spurs develop in both the acetabulum and femoral head, and osteoarthritis can develop.
• Hip Labrum Tears.
• Dysplasia, a condition in which the hip socket is abnormally shallow. This puts more stress on the labrum to keep the femoral head within the socket and makes the labrum more susceptible to tearing. The surgeon takes great care during arthroscopy of a dysplastic joint, as joint instability can develop after surgery.
• Snapping hip syndromes, which 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 and benefits from surgery.

In femoroacetabular impingement, bone grows abnormally around the hip socket (pincer impingement) or femoral head (cam impingement). Arthroscopy is typically used to trim the excess bone.

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