Hip arthroscopy is an excellent minimally invasive operation that allows thorough visualization of the hip joint needed for diagnosing and addressing various pathology, inside and outside the hip joint. So far there is no radiographic study that is entirely sensitive or specific enough for the diagnosis of cartilage lesions such as labial tears or chondral damage. Hip arthroscopy is a technically demanding procedure, requiring in depth knowledge and requires specialised training and education.
Indications for hip arthroscopy:
The acetabular labrum is a fibrous rim of cartilage around the hip socket which helps keep the head of the femur (thigh bone) inside the acetabulum (hip socket). It provides stability and seals the joint.
Acetabular labrum tears (labral tears) can cause pain, stiffness and other debilitating symptoms of the hip joint. The pain can occur if the labrum is torn, frayed or damaged. Labral tears are most often casued by trauma or developmental hip dysplasia.
Labral tears are extremely common in elderly people and less common in young adults.
Arthroscopic debridement treatment is not advised if you have any of the following conditions:
The patient will be admitted into hospital for a day or overnight. The procedure is performed either under general anaesthesia or spinal anaesthesia.
At the start of the procedure, the leg is put in traction. The hip is pulled away from the socket enough for the entire joint to be visible and for instruments to be inserted.
A small puncture (about the size of a button hole) is be made for the arthroscope through which the inside of the hip and its damage can be identified. X-ray control using an image intensifier is used to gain access to the joint.
Two or three small incisions (portals) are made just above the bony prominence of the hip and instruments are inserted; first to visualise and treat any spurs on the femoral neck or acetabulum and then traction is applied where the instruments gain access to the hip joint to treat any pathology intra-articulary on the hip. These instruments can also smooth off rough surfaces, remove loose pieces of cartilage and excise bony osteophytes that may be causing a problem.
Sufficient traction is applied to open the joint by 7-8mm.
Local anesthetic is injected into the hip and wound following the procedure.
Depending on the approach taken and the individual condition the above overview may vary.
As with any operation complications are possible but unlikely. Such complications associated with hip arthroscopy can include: