Patient Info / FAQ / Arthroscopic Hip Surgery


ARTIIROSCOPIC HIP SURGERY

Hip Arthroscopy is a relatively simple procedure whereby common disorders of the hip can be diagnosed and treated using keyhole surgery. Some conditions, which previously were not treated or required major open surgery, can now be performed using this technique. It is a useful diagnostic tool in investigation of hip pain.

HIP ANATOMY
The hip joint is composed of a ball and socket joint. The femoral head (ball) is the top of the femur (thigh bone) and the acetabulum (part of the pelvis) is the socket. These surfaces are both covered by articular cartilage, which is a specialized lining allowing smooth pain free motion of the joint. Damage to this lining results in arthritis. The joint is lined by a specialized synovial layer, which secretes fluid helping with lubrication. Inflammation of this layer is called inflammatory arthritis the most common of which is rheumatoid arthritis.

The lahrum is a specialized structure adding to stability of the joint. Damage to this structure can result in catching and pain in the joint. The capsule surrounds the synovitun stabilizing the joint.

INDICATIONS

  • Labral tears
  • Removal of loose bodies
  • Biopsy of lesions
  • Synovectomy
  • Diagnosis of pain
  • Infection

CONTRAINDICATIONS

  • Advanced arthritis
  • Stiff hip
  • Heterotopic ossification
  • Severe dysplasia

PRE-OP INSTRUCTIONS

  • Stop aspirin and anti-inflammatory medications 10 days prior to surgery as they can cause bleeding
  • Stop any naturopathic or herbal medications too 10 days before surgery
  • Continue with other medications unless specified



  • Notify your surgeon if you have any abrasions or pimples around the knee
  • Bring X-rays, MRI scans or other reports that are relevant to your surgery
  • Stop smoking for as long as possible prior to surgery

PROCEDURE

  • Under the anaesthetic, you are positioned on a special operating table with your legs strapped into boots to allow traction to be put on the hip
  • X-ray control is then used to mark out the landmarks used for surgery
  • Specially made instruments arc inserted into the hip joint again under x-ray control
  • Two or occasionally three small incisions 1-2 cm long are made in the skin



  • One incision is used to insert a camera, which displays the inside of the hip on a television monitor, and the other incision is to insert instruments for treatment of the problem
  • Following the procedure, local anaesthetic is injected into the hip and wound and the wounds are sutured
  • You will usually be in hospital overnight for pain relief

POST-OP

  • Dressing will be reduced prior to discharge
  • You will go home the same day or stay one night
  • A physiotherapist will see you before you are discharged and show you how to use crutches
  • Crutches are generally used for a few days



  • You will be given an appointment for approx. 7-10 days after the surgery
  • You should be able to drive after one or two weeks depending on your recovery
  • Time off work depends on your occupation; rest period usually lasts for one to four weeks after surgery

SURGICAL COMPLICATIONS

  • Infection: It is rare and can be superficial (skin) or deep (in the hip). If you have any redness around the wound or if you have any temperatures or are feeling unwell you need to contact me as soon as possible. If infection occurs you may require antibiotics either as an outpatient or in hospital. If the infection is deep you may require the hip to be washed out.
  • Nerve damage: There are a number of nerves surrounding the hip joint supplying sensation and muscles in the kg. There can be damage to superficial nerves, which can result in temporary or rarely permanent loss of sensation in the groin, thigh, scrotal or labial region. This can be a result of pressure during the procedure or damage with the insertion of instruments. There can be damage to nerves supplying the muscles of the leg resulting in weakness. This is however very rare.
  • Vascular injury: This can result in excess bleeding. Bleeding into the joint or soft tissue may require drainage.
    Failure to relieve pain: It is not common but unfortunately some operations may not be entirely successful in relieving pain.
  • Allergic reactions: Reactions to medications or materials used in the operating room may occur.



  • Thromboembolic problems: They refer to blood clot formation in the blood vessels of the legs. They usually occur in the leg veins where they arc known as deep venous thrombosis (DVT). They cause pain and swelling in the leg due to restriction of blood flow back to the heart. These may require blood-thinning medication in the form of injections or tablets.
  • Wound breakdown: This occurs when small areas of the wound may not heal and may need to be resutured. This can sometimes result from reaction to the sutures just under the skin
  • Instrument breakage: It can occur but is very rare. Instruments are constantly checked and repaired as required.
  • Scarring: It may be not too visible or even really obvious.
  • Joint stiffness: It can occur no matter what the procedure; this is minimized and treated with physiotherapy.
  • Limp: It can occur from muscle weakness

ANY MEDICAL COMPLICATION

It can occur especially if you already have a pre-existing medical problem. Such complications include heart attack, stroke, kidney failure, pneumonia, bowel obstruction, bladder infection or obstruction, etc. Serious medical problems can lead to ongoing health concerns, prolonged hospitalization or rarely death.