Hip Arthroscopy: With the advancement of arthroscopic techniques, many procedures can now be performed arthroscopically on the hip joint. Hip arthroscopy involves making 2 to 4 small incisions, approximately 1 cm each, to access the joint with a camera and special instruments without surgically opening the hip joint. This method allows for surgery to be completed without cutting the muscles in front of the hip joint, enabling patients to rehabilitate more quickly and return to their daily lives sooner.
When is Hip Arthroscopy Performed?
Hip arthroscopy is particularly indicated for conditions arising directly from the hip joint. The most common indications include:
- Hip impingement syndrome (FAS) (a painful condition caused by deformation of the hip joint)
- Removal of intra-articular free fragments
- Cleaning and repairing labral tears
- Treatment of intra-articular cartilage lesions
- Removal of simple tumors within the joint
- Obtaining biopsies from the joint
What Are the Advantages of Hip Arthroscopy?
The hip joint is anatomically located quite deeply. To access it through open surgery, one must navigate between several muscles and pay special attention to surrounding nerves and blood vessels. Hip arthroscopy, performed through only 1-2 small incisions, minimizes damage to the structures in front of the hip. This allows patients to return to their daily activities very quickly.
Another advantage is that the direct access to a deep joint results in a shorter surgical time compared to open surgery.
The procedures performed through this method can prevent the progressive deterioration of the hip and postpone the need for total hip replacement surgery.
How is Hip Arthroscopy Performed?
Hip arthroscopy is performed in an operating room using a specialized table. Initially, anesthesia is administered to ensure you do not feel any pain. The hip is then subjected to traction to create some space within the joint, and the incision points are determined with the help of a fluoroscope, a device that provides continuous X-ray images.
The first entry point is made on the side of the hip joint, allowing visualization of the interior of the joint. If necessary, a second incision is made in front of the hip joint for required interventions.
Once inside the hip joint, wear and tear of the cartilage, tears and wear in the labrum (the structure that enhances joint congruence), ligaments, and other structures are assessed, and necessary treatments are performed.
The average duration of hip arthroscopy surgery is between 30 minutes and 2 hours.
Rehabilitation After Hip Arthroscopy
Many patients begin to mobilize with the aid of crutches the day after hip arthroscopy. Depending on the procedure performed, patients may be able to bear weight on their leg. Movement and strengthening exercises for the hip joint are initiated, and many patients are discharged home the day after surgery. Patients are given a home exercise program, typically transitioning to active rehabilitation after about 2 weeks. By the 2-3 week mark, patients return to their daily activities and can resume sedentary work. Those with more physically demanding jobs can usually return to work after about 1 month.
When Can I Resume Sports After Hip Arthroscopy?
Patients can typically start walking and running around the 1-month mark, depending on the condition treated with hip arthroscopy. For those who have undergone labral repair or cartilage surgery, this period may vary from 6 weeks to 3 months.
Patients can engage in strengthening and balance exercises up to 3 months, after which sport-specific training can begin. Generally, patients can return to competitive sports between 4 to 6 months post-surgery.
What Are the Possible Risks of Hip Arthroscopy?
Due to the small incisions used in hip arthroscopy, the risks are lower compared to open surgeries. Rarely, there is a risk of damage to the nerves and vessels in front of the hip, leading to numbness or tingling on the outer upper thigh. Additionally, traction during surgery may cause temporary erectile dysfunction in men and arousal disorders during sexual intercourse in women. Most of these complaints resolve spontaneously within 4-6 weeks. There may also be temporary dysfunction of the sciatic nerve due to traction.
Overall, hip arthroscopy is a successful surgical procedure that offers promising results in preserving hip function.
Questions and Answers
I have pain in my hip joint, but how can I tell if it’s from my hip or my back?
Hip joint pain typically radiates to the groin and is exacerbated by hip movements. Back-related pain usually manifests at the back of the hip and occurs when transitioning from sitting to standing.
I was told I have impingement in my hip joint. Is open surgery or hip arthroscopy more suitable?
While there are many factors that can cause impingement in the hip joint, hip arthroscopy is often preferred in experienced hands due to better assessment of the joint interior and easier rehabilitation.
I am active in sports. When can I return to playing after surgery?
Depending on the condition treated with arthroscopy, rehabilitation for a return to competitive sports usually begins between 6 weeks to 3 months.
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