Hip Arthroscopy Surgery


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


>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. 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.
Planning for Surgery


If you are having arthroscopy, you will need a physical examination from a physician to assess your health. He or she will identify any problems that may interfere with the surgery.
If you have certain health risks, a more extensive evaluation may be necessary before your surgery. Be sure to inform your orthopaedic surgeon of any medications or supplements that you take. He or she may tell you which medications to stop and which to take prior to surgery.
If you are generally healthy, your hip arthroscopy will most likely be performed as an outpatient. This means you will not need to stay overnight at the hospital.
Before the operation, you will also be evaluated by a member of the anesthesia team. 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. Orthopaedic surgeon and Anesthesiologist will talk to you about which method is best for you.


Surgical Procedure


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.
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
The length of the procedure will depend on what your surgeon finds and the amount of work to be done.


Complications


Complications from hip arthroscopy are uncommon. Any surgery in the hip joint carries a small risk of injury to the surrounding nerves or 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.


Knee Arthroscopy Surgery


Arthroscopy is a common surgical procedure in which a joint (arthro-) is viewed (-scopy) using a small camera. Arthroscopy gives doctors a clear view of the inside of the knee. This helps them diagnose and treat knee problems.
Technical advances have led to high definition monitors and high-resolution cameras. These and other improvements have made arthroscopy a very effective tool for treating knee problems.


Description


Arthroscopy is done through small incisions. During the procedure, orthopaedic surgeon inserts the arthroscope (a small camera instrument about the size of a pencil) into your knee joint. The arthroscope sends the image to a television monitor. On the monitor, surgeon can see the structures of the knee in great detail.


Surgery




Almost all arthroscopic knee surgery is done on an outpatient basis.


Anesthesia


When you first arrive for surgery, a member of the anesthesia team will talk with you. Arthroscopy can be performed under local, regional, or general anesthesia.


Local anesthesia numbs just your knee
Regional anesthesia numbs you below your waist
General anesthesia puts you to sleep

Procedure


The orthopaedic surgeon will make a few small incisions in your knee. A sterile solution will be used to fill the knee joint and rinse away any cloudy fluid. This helps the orthopaedic surgeon see your knee clearly and in great detail.


Your surgeon’s first task is to properly diagnose your problem. He or she will insert the arthroscope and use the image projected on the screen to guide it. If surgical treatment is needed, your surgeon will insert tiny instruments through another small incision. These instruments might be scissors, motorized shavers, or lasers.
This part of the procedure usually lasts 30 minutes to over an hour. How long it takes depends upon the findings and the treatment necessary.
Arthroscopy surgery for the knee is most commonly used for:


Removal or repair of torn meniscal cartilage
Reconstruction of a torn anterior cruciate ligament
Trimming of torn pieces of articular cartilage
Removal of loose fragments of bone or cartilage
Removal of inflamed synovial tissue
Your surgeon may close your incisions with a stitch or steri-strips (small bandaids) and cover them with a soft bandage. You will be moved to the recovery room and should be able to go home within 1 or 2 hours. Be sure to have someone with you to drive you home.


Recovery


Recovery from knee arthroscopy is much faster than recovery from traditional open knee surgery. Still, it is important to follow your orthopaedic surgeon’s instructions carefully after you return home.
1. Swelling
Keep your leg elevated as much as possible for the first few days after surgery. Apply ice as recommended by your doctor to relieve swelling and pain.
2. Dressing Care
You will leave the hospital with a dressing covering your knee. Keep your incisions clean and dry. Your surgeon will tell you when you can shower or bathe, and when you should change the dressing.
Your surgeon will see you in the office a few days after surgery to check your progress, review the surgical findings, and begin your postoperative treatment program.
3. Bearing Weight
Most patients need crutches or other assistance after arthroscopic surgery. Your surgeon will tell you when it is safe to put weight on your foot and leg. If you have any questions about bearing weight, call your surgeon.
4. Driving
Your doctor will discuss with you when you may drive. This decision is based on a number of factors, including:


The knee involved
Whether you drive an automatic or stick shift
The nature of the procedure
Your level of pain
Whether you are using narcotic pain medications
How well you can control your knee
Typically, patients are able to drive from 1 to 3 weeks after the procedure.
5. Medications
Your doctor will prescribe pain medication to help relieve discomfort following your surgery. He or she may also recommend medication such as aspirin to lessen the risk of blood clots.
6. Exercises to Strengthen Your Knee
You should exercise your knee regularly for several weeks after surgery. This will restore motion and strengthen the muscles of your leg and knee.
Therapeutic exercise will play an important role in how well you recover. A formal physical therapy program may improve your final result.


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