Hip arthroscopy is a procedure where a surgeon uses fibre optic technology and small arthroscopic instruments to access the hip joint to treat a variety of problems via minimally invasive keyhole surgery.
Conditions treated using hip arthroscopy
Dr Arora has a special interest in young adult hip pain and has undergone extended fellowship training in hip arthroscopy, allowing him to address many problems including:
The acetabular labrum is a fibrocartillagenous extension of the bony rim of the hip socket. It effectively deepens the socket providing a suction seal to the ball and socket articulation of the hip, affording more stability and improved fluid lubrication in the joint.
Tears to the labrum are a common source of pain. The labrum can often be debrided or repaired to improve the pain, however this is not always necessary. It is often more important for the surgeon to identify why the labrum tore, usually due to a shape problem of the hip joint.
femoroacetabular impingement (FAI), a condition that occurs during skeletal development, where after skeletal maturity there remains a shape problem of the hip joint. Either a bony bump on the femoral head and neck junction (also known as a cam lesion) or an excessive bony rim of the acetabular socket (pincer lesion), leads to impingement of bone and labrum as a source of pain. Arthroscopy can address these lesions and help to improve symptoms by trimming the bone back to normal shape and repairing the labrum.
Bony and cartilaginous loose bodies can form in the joint causing pain, catching and clunking. These can be removed arthroscopically.
Ligamentum Teres Injuries
This strong ligament in the hip joint can be damaged, particularly in athletes and young females that are hypermobile with excessive rotation in the hips (typically dancers and gymnasts). Ligamentum teres injuries may also occur following a traumatic injury. Investigations including MRI, may not diagnose the torn ligament.
Despite many advances in imaging, the cause of some pain cannot be diagnosed and therefore be adequately addressed. Arthroscopy can be used by surgeons to look inside the joint to help with the diagnosis.
Not all patients will require all of the steps listed below. The rehabilitation may vary depending on your specific pathology.
- The procedure is done under a general anaesthetic
- Gentle traction is placed on the operated limb to allow access to the joint
- Two or three keyhole incisions are made by Dr Arora to allow passage of the arthroscopy instruments in to the hip joint
- The central compartment (acetabulum, labrum, pincer and ligamentum teres) pathology is addressed
- The peripheral compartment (femoral head and cam lesion) pathology is addressed
- Dr Arora takes x-rays during the procedure to help confirm correct shape restoration
- The joint is taken through a full range of motion to confirm the impingement has been adequately removed
- The keyholes are dressed
The post-operative recovery consists of
- Discharged on the day of, or next day after surgery
- Partial weight bearing through the operated hip immediately with crutches for a period of 2-4 weeks (This may vary depending on what was required during the procedure)
- Follow Dr Arora’s rehabilitation prescription
- After hip arthroscopy, up to 95% of patients return to sport, and up to 85% of patients return to the same level of sport, in well-selected patients.