Arthroscopy of the hip uses specialized arthroscopic instruments to treat various unusual disorders of the hip. The primary indications for hip arthroscopy
- Removal of loose bodies (usually cartilage)
- Debridement/repair of labral tears (the labrum is an O-ring of cartilage around the hip socket)
- Removal of bone spurs that cause hip pain (femoral or acetabular spurs)
- Removal of pathologic synovium (joint lining)
- Sometimes hip arthroscopy can provide a diagnosis when other means (e.g., MRI) fail
- Hip arthroscopy with thermal shrinkage has proved useful in persons with instability of the hip
- Femoroacetabular impingement, which is the removal of painful bone spurs around the hip
- People who have pain that can be localized to the hip, but with minimal findings on x-ray
Procedure Details
The patient, after being anesthetized, is placed in traction on a specialized operating room table. The traction is necessary to pull the hip apart slightly to allow us to insert instruments into the joint safely, without injuring the cartilage. All this is done with the help of a portable x-ray machine to make sure the instruments are positioned correctly. A pump device is used to fill the joint with saline. Then an arthroscope is used to view the joint; once a problem is identified, it is treated with a variety of instruments. It includes :- Treatment of the Labrum: Labral tears are treated during hip arthroscopy with either refixation (repair of the labral tissue using suture) or debridement (removal of a small portion of the labrum), depending on the tear type and the patient’s age.
- Shaving of the Bone: When abnormalities of the bony shape of the hip ball or socket occur, such as in FAI or hip impingement. specialized bone shavers are used to remove the excess bone and recontour the hip.
- Removal of Inflamed Tissue: Most of the pain you feel from you hip is due to nerve endings that have become irritated in the presence of inflammation. Much of this inflamed tissue is torn labrum and synovium, the lining of the joint. This inflamed tissue is shaved away during hip arthroscopy.