Hip arthroscopy may help postpone the need for hip replacement surgery
Hip arthroscopy may help postpone the need for hip replacement surgery – or eliminate it altogether. At the very least it provides an opportunity to delay major reconstructive procedures such as hip replacement surgery.
Hip arthroscopy is performed through small incisions using a camera to visualize the inside of a joint. Through several small incisions (about 1 centimeter each) your surgeon will insert a camera into one incision, and small instruments through the other incisions.
Causes of Hip Pain
Arthritis in the hip pain to the destruction of the hyaline articular cartilage. The cartilage between bones provides smooth surface and lubrication necessary for the movement. If this cartilage is destroyed – through a genetic defect, trauma, infection or tumor – pain, joint stiffness and decreased range of motion may result.
Arthritis of the hip causes a gradual loss of this cartilage; in its early phases, it triggers a vicious cycle. The arthritis changes the chemical make-up in the joint fluid, which leads to irritation of the lining and fraying of the joint. This reaction, in turn, causes more inflammation and more fraying. The hip pain associated with this condition is unique among joint pain problems in that it can keep one from sleeping through the night: hip pain from rolling over can jolt a person from a deep sleep.
Previously, there were few treatment options for hip pain, and a hip replacement was virtually inevitable. While this technique has improved countless lives, there exists a built-in obsolescence with every implant. “There’s a fundamental flaw in the concept of taking out someone’s bone and cartilage and putting in metal and plastic,” Dr. Sharma notes. “Even under the best possible circumstances, the implant wears out and will need to be replaced. I predict hip implants will eventually be made of more natural material that won’t undergo the same stresses and wear-out, but this may be several years down the road.”
In the interim, hip arthroscopy, which actually helps break the vicious cycle caused by the arthritis, may postpone some of the damage. “For this reason, I believe hip arthroscopy offers patients with hip pain a viable alternative,” Dr Sharma adds.
What are the benefits of hip arthroscopy
Hip arthroscopy conservative surgical approach to reduce or cure hip pain. Hip arthroscopy is an innovative new procedure which is less invasive than the open surgical alternatives and patients are sent home the same day.
Arthroscopy allows for minimal scarring, faster recovery, and helps to diagnose and treat early causes of arthritis, in many cases preventing it altogether.
In young active individuals hip arthroscopy could be an alternative to hip replacement surgery. There are minimal risk factors associated with hip arthroscopy
What is the benefit of hip arthroscopy compared to open surgery?
The nice part about hip arthroscopy is that it is much less invasive than traditional hip surgery. This means:
- Early rehab
- Accelerated rehab course
- Outpatient procedure
- Smaller incisions
- Early return to sport
What conditions can be treated with hip arthroscopy?
- Labral Tear
The labrum of the hip is a cuff of thick tissue that surround the hip socket. The labrum helps to support the hip joint. When a labral tear of the hip occurs, a piece of this tissue can become pinched in the joint causing pain and catching sensations.
- Loose Bodies
Loose bodies are pieces of cartilage that form within the joint. They look like small marbles floating within the joint space. These loose bodies can become caught within the hip during movements.
- Snapping Hip Syndrome
Snapping hip syndrome has several causes, some of which can be treated with hip arthroscopy. If something is catching within the hip joint, hip arthroscopy can be used to relieve this snapping. Also, hip arthroscopy can be used to perform a psoas tendon release in cases of internal snapping hip syndrome.
- Cartilage Damage
In patients with focal cartilage damage, meaning not widespread arthritis, hip arthroscopy may be helpful. These patients may sustain an injury causing a piece of cartilage to break away from the surface of the bone. These patients may benefit from removal of that piece of cartilage.
- Early Arthritis
This is a controversial topic, as patients who have arthritis pain generally will not benefit from a hip arthroscopy. The patients who tend to benefit have specific finding of impingement (pinching) within the hip joint, and may benefit from removal of the bone spurs causing this impingement. This is only possible in the very early stages of arthritis, and even then may not offer relief of symptoms.
Who is a candidate for hip arthroscopy
Easy question, anyone with ongoing hip pain who has failed conservative management. Sometimes there is confusion between hip and low back pain. One way to tell is if the pain resides in the hip groin area or about the hip joint. Pain above the waist is typically back pain.
What are the possible complications from hip arthroscopy?
The most concerning complications of hip arthroscopy have to do with several important nerves and blood vessels that surround the joint. Nerve injury is uncommon, but can be a significant problem. The most commonly affected nerves include the sciatic nerve, the lateral femoral cutaneous nerve (sensation to the thigh), and the pudendal nerve. Injury to any of the nerves can cause pain and other problems.
Other possible complications from hip arthroscopy include potential injury to normal structures, infection, and continued pain after the surgery. The rate of these complications is low, but patients need to understand the potential prior to undergoing a hip arthroscopy.
Consultation can be arranged with Dr. Sharma if you have any questions about your hip pain.