How the Arthroscope has Changed the Face of Hip Surgery

Jun 19, 2018 | Articles

How the Arthroscope has Changed the Face of Hip Surgery

Arthroscopy of the hip, knee, and other joints has transformed the nature of orthopaedic surgery. Over the course of 70 to 80 years and, in some cases, considerably longer, our joints are subjected to an incredible amount of wear and tear. Those involved in walking and running that serve rather like the shock absorbers in a car, are commonly the worst affected, and like those important vehicle parts, they often need to be replaced. Until relatively recently, however, the replacement of human joints was no more than a dream, so instead, those affected simple endured the pain and continued to walk with a stick until no longer possible. Today, not only are knee and hip repairs and replacements commonplace but, thanks to arthroscopy, they are often accomplished by means of surgical techniques that are only minimally invasive.

Often referred to as keyhole surgery, it is characterised by the need for only one or two tiny incisions, rather than the need to expose the entire joint. In order to perform an operation in this fashion, the surgeon must have a clear view of the joint and what is going on beneath the surrounding muscle and connective tissue. That view is provided by a modified endoscope – a narrow tube with a miniature video camera and light at its tip that produces a magnified image on a monitor, allowing the surgeon to inspect damage and manipulate instruments inserted through additional keyhole incisions.

Hip arthroscopy, like the more radical approach, is able to provide the patient with welcome relief from pain and discomfort and, where the damage is particularly advanced, completely restore his or her former mobility. However, because the arthroscopic technique avoids all need for a surgeon to fully expose the joint, the risk of infection is greatly reduced, as is the extent of blood loss and subsequent bruising and swelling. This, in turn, means that the post-operative recovery period will usually be considerably shortened, thus allowing the patient to resume a normal life. Those with more sedentary jobs can often return to work after a week or two.

There are many reasons why it may be necessary for someone to undergo hip arthroscopy. Of these, the two most common are to remove loose fragments of cartilage or bone that can cause joint stiffness and  pain, or to repair a torn labrum – the cartilage that lines the rim of the socket part of the ball-and-socket-type joint. Less commonly, the procedure may be performed to treat the condition known as FAI or femoroacetabular impingement – a condition caused by bony outgrowths or spurs forming on the head of the femur or along the acetabulum, which can then cause damage to soft tissue and pain upon movement.

First developed as an aid to diagnoses, arthroscopy is still used extensively to examine the hip, knee, and other joints. It is often a preliminary investigation undertaken prior to a total or partial joint replacement. The use of an arthroscope provides the surgeon with a means to supplement the data from X-ray images with a live view of the joint that reveals the nature and the extent of damage that better enables him or her to determine the best course of treatment.