The hip is a ball-and-socket joint that provides us with balance and support as we stand, walk, and run. It is also one of the body's largest joints. The hip joint consists of two parts: the hip socket, which is formed by the acetabulum, and the ball, which is also known as the femoral head. Soft tissues such as muscle, cartilage, ligaments, and tendons connect the joint as well as help provide stability. Other key parts of the hip joint that contribute to its stability include the labrum, which is cartilage that rims the hip socket and acts as a cushion; the synovium, which provides synovial fluid that keeps the hip joint lubricated; and the articular cartilage, which allows the bones to slide easily across each other.
Pain in or around a joint can be related to a wide variety of problems, including wear and tear over time or acute damage, and it can keep you from doing even simple, daily tasks. Pain in the hip joint can be the result of damage to soft tissues, such as the articular cartilage or labrum, or other hip issues, like inflammation due to arthritis or damage from loose bodies of bone or cartilage. For serious damage, arthroscopic hip surgery is often used to repair such problems, like labral tears, or can be used to help with diagnosing hip pain.
Arthroscopy is a minimally invasive surgical procedure that allows a surgeon to see inside a joint as well as diagnose and treat problems occurring in the joint. To do this, the surgeon uses a tiny instrument with a camera called an arthroscope and small surgical tools to examine or repair the soft tissues inside or around the joint. Arthroscopy can be performed on most joints, but it is most commonly used on the knee, shoulder, elbow, ankle, hip, and wrist.
Before Undergoing Hip Arthroscopy
History of Injury: Although some people may need hip arthroscopy after an injury, more often, arthroscopy is performed on people who are dealing with the effects of hip arthritis, including rheumatoid arthritis, or autoimmune-related chronic joint inflammation; post-traumatic arthritis, which occurs after injury; and osteoarthritis of the hip, or joint degeneration caused by years of wear and tear on the hip joint.
Diagnosis: Your doctor will ask questions about your general health as well as your hip pain and how it is impacting your ability to function. He or she will also perform a physical exam to assess the strength, range of motion, and stability of your hip. To better understand the location and the extent of the damage, you will have X-rays taken of your hip. Depending on your situation, your surgeon may also order blood tests or an MRI.
Treatment: One of several arthroscopic procedures may be used to treat or diagnose the problem.
Initial: Before recommending hip arthroscopy, your doctor may suggest taking anti-inflammatory medications or over-the-counter pain relievers. You may also be advised to avoid activities that could make your pain worse.
Long-Term: If nonsurgical treatments are not helpful or no longer relieve pain, hip arthroscopy could be a good option for you.
Indications for Surgery: Arthroscopic surgery can be especially helpful if you have torn ligaments or tendons, hip instability, arthritis, loose tissue, or a dislocation or bone spur.
A number of hip injuries and conditions are treated arthroscopically, including:
- Hip impingement, including cam impingement
- Labral tears
- Loose bodies
Your Surgery, Recovery, and Rehabilitation
Surgery: The type of arthroscopic surgery you have will depend on your unique situation and needs.
Regardless of the type of surgery you need, during the procedure, your orthopedic surgeon will insert the arthroscope through small incisions into the affected area. An image of your hip joint is then projected in real time for your surgeon to view. Several other incisions are also made that allow your surgeon to move the camera to other positions to see the cartilage of each bone, the ligaments, and the joint lining. He or she will also insert various surgical tools through these openings throughout the procedure.
Post-Surgery: Hip arthroscopy involves the use of either regional anesthesia or general anesthesia. Arthroscopic procedures are often performed on an outpatient basis, in which case, you will be able to go home the day of your procedure. If you are experiencing swelling after your hip arthroscopy, icing your hip can help reduce the inflammation. You can also use over-the-counter pain medications while you recover. Although you should be able to go home a few hours after your procedure, you will need to have a friend or family member drive you.
Rehabilitation: Recovery time can take several weeks or months, and you will likely need to use crutches during part of this time. If your hip arthroscopy included a repair, your surgeon may recommend physical therapy to help you regain strength and motion in your hip. Both the type and length of this therapy depend on the type of procedure you had.
Risks and Complications: As with any surgery, there is a risk of infection or blood clots. You should also avoid heavy lifting or hard manual labor.
You should seek out an experienced orthopedic surgeon to perform your hip arthroscopic surgery. This clinician should not only be skilled at performing the surgery but also have the ability to accurately assess the extent of the damage prior to surgery.
The Hip & Sports Medicine Expert at Litchfield Hills Orthopedic Associates
Our fellowship-trained hip surgeon, Dr. Leigh Brezenoff, is experienced and skilled in providing expert care for our hip and sports medicine patients. Though many hip conditions can be treated conservatively without surgery through the use of anti-inflammatory medications, injections, or physical therapy, there are injuries or conditions that may require hip surgery. If surgical intervention is necessary for you, Dr. Brezenoff has the advanced training and expertise to perform your hip arthroscopy as well as several other advanced procedures.
Dr. Brezenoff also offers a number of specialized nonsurgical joint treatments, including cortisone joint injections and viscosupplementation.
At Litchfield Hills Orthopedic Associates, our expert specialist understands the first step towards reducing your hip pain and restoring your health is a proper diagnosis to determine the specific cause of your pain. Schedule a consultation with our specialty-trained hip doctor today, and discuss your condition and treatment options. You can request an appointment online or call (860) 482-8539 and be seen in Torrington or Bristol.