Understanding Hip Arthroscopy and Why It Is Sometimes Necessary

May 29, 2020 | Articles

If you have been experiencing trouble with one or both hips for some time, then you know all too well how debilitating pain and lack of mobility in this region can be. After various futile treatments and months (or even years) of frustration, your specialist might have suggested a hip arthroscopy to you. Though a standard treatment, not many people understand it or what it involves, which is why we want to educate each patient on why it is sometimes needed and the long-term health outcomes to expect.

First, Let’s Explore the Anatomy of Our Hips

As one of the most essential joints in the body, our hips allow us to move, from first crawling as a baby to running that marathon. These are strong, flexible joints that also carry the weight of our body and bear the force of powerful leg muscles. Because our hips are so flexible, they allow for a range of motion as proven by the fact that it is possible to swing the leg out in almost any direction.

Your hip is what is known as a “ball-and-socket” synovial joint. The “socket” of the joint is a cup-shaped structure formed by the acetabulum, which is located on the large pelvis bone. The femoral head (the top of the thigh bone) forms the ball that fits into the socket. Both the ball and socket are lined in articular cartilage tissue, which is slippery and allows for smooth gliding of the bones, thus avoiding any friction. Around the acetabulum socket is a rim of fibrocartilage called the labrum, which forms a gasket around the socket and keeps the joint ball in place. Surrounding the entire joint are ligaments that encapsulate and hold the joint together. Pain and lack of mobility arise when one or more of these structures damages the labrum, surrounding soft tissues, or articular cartilage.

When a Hip Arthroscopy is Helpful

Nonsurgical treatments are usually recommended for painful joints first, such as rest, supplements, anti-inflammatory medication or injections, and physical therapy. Failure to respond to these more conservative treatments might mean your doctor will recommend a hip arthroscopy. Below are some of the most common conditions that may warrant the procedure:

  • Dysplasia: A condition where the socket is too shallow and does not fully cover the ball of the joint. A partial or complete dislocation of the joint is possible, and the labrum is more susceptible to tearing.
  • Femoroacetabular impingement (FAI): A condition that falls into two categories, pincer impingement and cam impingement. In pincer impingement, extra bone grows along the acetabulum and covers too much of the femoral head. In cam impingement, too much bone grows round the femoral head itself. In both cases, the bone overgrowth can damage the surrounding soft tissues.
  • Snapping joint syndromes: Conditions that result in a tendon damaged from repeated friction against the joint.
  • Loose bodies: When parts of the bone or cartilage become loose and begin to move about.
  • Synovitis: Inflammation of surrounding tissues

Hip arthroscopy has been known to successfully treat the above conditions, as well as labral tears, cartilage damage, joint infection or sepsis, bone cysts, ligamentum teres tears, and other conditions.

Why Choose Hip Arthroscopy? 

Although the process does involve invasive surgery, it remains a routine procedure. During the operation, very few small incisions are made, and a minuscule camera (called the arthroscope) is inserted into the joint to allow the surgeon to see the surrounding structures on a video monitor. This allows the surgeon to use thin surgical instruments to complete the procedure. Smaller incisions and precise, minuscule devices mean there is no need to cut into large areas of muscle, cartilage, or bone to access the joint. In traditional hip surgery, muscles and tendons are detached, and the joint is deliberately dislocated to allow access to the area.

Being less invasive means that a hip arthroscopy allows for far less post-operative pain, as well as a much quicker recovery. Normal activities can usually once again be resumed between three weeks to a month, and returning home after surgery generally happens within a day.

If you are looking to find out more about arthroscopy procedures or wish to make an appointment with us, contact us at 012 807 0335 or send us an email at admin@drdevos.co.za today.