Facts a Prospective Patient Needs to Know About Hip Arthroscopy
Perhaps the first thing for a prospective patient to bear in mind when he or she is faced with the possibility of undergoing hip arthroscopy is that this is essentially an exploratory procedure. It is undertaken to determine the underlying cause of persistent pain and discomfort that may also be affecting the movement of this much-used and sometimes abused joint. It is the diagnostic procedure of choice in cases where the results of an X-ray of the region reveal nothing of any significance or may appear equivocal.
The concept of viewing the internal structure of a joint directly, rather than being restricted to interpreting a far-less distinct black and white X-ray image is not new. A professor from Tokyo named Kenji Takagi is said to have first used a cystoscope in 1918 to examine knees affected by TB. Quickly adapted for examination of the shoulder joint, hip arthroscopy emerged only some time later, and as stated, was primarily used as a diagnostic tool. Today, however, a number of treatment procedures on these and other joints are now undertaken using this procedure.
Whether used for diagnostic or therapeutic purposes, the most obvious advantage of this type of procedure, from the patient’s point of view, is that only a tiny incision of just a few millimetres is required. This means that his or her recovery time will be greatly reduced as compared with the earlier use of open surgery, and any scar will be negligible.
A hip arthroscopy is normally carried out under a general anaesthetic, but effective anaesthesia may also be achieved by means of a local or a spinal injection, where this is indicated or preferred. During the procedure, the patient can expect to experience no more than an occasional, vague sensation of tugging.
Following the initial keyhole incision, an endoscope is carefully inserted. At its tip, a light serves to illuminate the interior of the joint, while a miniature camera transmits a video image of the scene, by means of a fibre-optic cable, to the surgeon conducting the hip arthroscopy, who will view it on a screen. The real-time image allows the surgeon to guide the scope and to locate any obvious problems.
Perhaps even more importantly, hip arthroscopy can also provide the surgeon with a route by which to correct some of the more common joint problems that may be exposed during the exploratory stage of this procedure. The list of possible interventions that may now be conducted arthroscopically in and outside this major joint has grown steadily, and is now quite extensive. Among the simplest of these are the removal of lose material, such as bone and cartilage fragments, and “washouts” to clear the joint of infection.
One of the more complex procedures that are commonly undertaken by means of a hip arthroscopy is the repair of a torn labrum – the ring of fibrocartilage that lines the rim of the socket component of the joint known as the acetabulum. Other procedures carried out in this fashion include relief of sciatic nerve compression, repairs to injuries of the ligamentum teres femoris, and surgical treatment of psoas tendinopathy when it fails to respond adequately to rest, physiotherapy, massage, and non-steroidal anti-inflammatories, to name just a few.
Unlike many surgical procedures, hip arthroscopy has been shown to carry little or no risk of complications. As a result, anyone who may be referred for this type of procedure need have no worries regarding its safety or its equally high success rate. In practice, counting just knee ops alone, surgeons are now performing more than a million orthopaedic treatments by means of this minimally-invasive type of keyhole surgery every year, and in countries all over the world.
Although falling well short of the seven figure total, according to a report by the South African National Joint Registry, in 2015, the eleven hospitals participating in their survey performed just over 1 810 primary hip arthroscopies. The need for such procedures is increasing, so it is comforting to know that, simultaneously, so too is the reputation of one South African centre dedicated to this type of keyhole surgery and other state-of-the-art procedures in the field of orthopaedics.
Join the many patients, both local and international, who owe their thanks to the Pretoria Hip, Knee and Shoulder Surgeons for their return to full mobility and freedom from joint pain following hip arthroplasty at the hands of Dr Jan De Vos and his team.