FAQ: hip arthroscopy

Leading orthopaedic surgeon Mr Daniel Phillip Thomas answersa your frequently asked questions about hip arthroscopy.

What is hip arthroscopy?

Hip arthroscopy is keyhole surgery on the hip joint. It's usually a day case procedure and it helps the surgeon deal with any pathology inside the hip joint.

How is this process different from other hip surgeries?

Hip arthroscopy is minimally invasive surgery, so there are usually just two or three small cuts on the outside of the hip, and then a camera is introduced into the hip joint to confirm the diagnosis.

Other instruments are then introduced in order to able to deal with issues such as labral tears, as well as other issues inside the hip joint.

Who is an ideal candidate for hip arthroscopy?

Younger patients with particular hip pathologies are good candidates for this type of surgery. For example, patients with a condition known as hip impingement, where the head of the femur does not match the shape of the socket.

Labral tears can be produced as a result of this or from injuries. They can be repaired using this keyhole method and so can the shape of the femoral head can be sculpted in order to give a more normal shape and avoid further damage to the joint.

What are the potential risks and complications associated of procedure?

Hip arthroscopy is associated with a very low complication rate. The main risks of surgery that we always worry about are infection and thrombosis. The risk of infection is very low because there is fluid constantly going through the hip to wash the hip out.

Thrombosis is also a possible, but extremely low risk related to hip arthroscopy because most patients are fully weight-bearing and mobile after the procedure.

There are some specific things I always warn patients about. One of these is that there may be some damage to a small nerve that supplies the outside of the skin. In worst-case scenarios, the patient can have a some numbness on the outer side of the hip joint.

However, this nerve only supplies skin, it's not a motor nerve, meaning that there is no weakness afterwards. The majority of patients  feel well after surgery, but there's always a risk that their condition is not fully resolved, particularly if they've got some arthritic change in the joint.

How long does the recovery process typically take after a hip arthroscopy?

Recovery after the process is patient specific and dependent on what the pathology is in the joint. Generally, for example, with labral tear, patients would be walking fully weight bearing, perhaps with the aid of crutches for the first first 10 days or so. After this,  they would be having their sutures removed at two weeks and then straight into physiotherapy.

The amount of time required off work is quite short, normally around about three to four weeks for most people, unless they have a very manual job. They would have to avoid things such as twisting and turning,  keeping their movement of the hip in a straight line for the first six weeks. Typically sports people are having this type of surgery and normally returm to their sport at about three months after the operation.

Are there any long-term effects or considerations that a patient should be aware after undergoing this kind of procedure?

If a patient has significant arthritic change in the hip joint, identified either by an X-ray or by MRI scanning, they may not be an ideal candidates for the procedure, because there is no real cure for cartilage available to the orthopaedic surgeon apart from replacement surgery.

My advice would be that if there is significant arthritic change, then it's probably not going to be a good outcome for the surgeon or the patient by just performing just a debridement or tidier procedure inside the hip.

If you would like to book a consultation with Mr Thomas, do not hesitate to do so by visiting his Top Doctors profile today.