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Hip arthroscopy is a highly effective and minimally invasive surgical procedure that provides a clear view of your hip joint, helping to diagnose and treat various issues both inside and outside the joint.
During the procedure, a small fibre-optic instrument called an arthroscope is inserted into the joint. The arthroscope is equipped with a camera, which allows the surgeon to visualise the internal structures of the hip. The images captured by the camera are displayed on a TV monitor, enabling the medical team to carefully evaluate and address the specific issues present.
Please find below more detailed information on the hip arthroscopy procedure, including what to expect prior to, during, and after the surgery, as well as information on the recovery period.
Hip arthroscopy is recommended for patients experiencing persistent hip pain that has not responded to nonsurgical treatment. The procedure is used to relieve painful symptoms that result from damage to the labrum, articular cartilage, or other soft tissues surrounding the joint.
Some common indications for hip arthroscopy include:
Arthroscopic debridement treatment is not advised if you have any of the following conditions:
As with any surgical procedure, there are potential risks and complications, although they are relatively uncommon. Possible complications following hip arthroscopy can include:
Hip arthroscopy is a technically demanding procedure that requires in-depth knowledge and surgical expertise. A/Prof Munjed Al Muderis has extensive experience in this area, having developed a technique for hip arthroscopy that avoids the use of traction, the standard method under which hip arthroscopy is performed. This approach helps to prevent unnecessary complications and discomfort.
The procedure is performed under general anaesthesia or spinal anaesthesia.
A small incision will be made in the skin for the arthroscope, through which the inside of the hip and its damage can be identified.
X-ray control, facilitated by an image intensifier, is used to access the joint.
Fluid is pumped into the joint through the arthroscope to maintain a clear view and control any bleeding.
What the surgeon sees within the hip joint is projected onto a screen, allowing them to assess the joint thoroughly and decide on the appropriate treatment.
Once the cause of pain is established, two or three small incisions (portals) are made just above the bony prominence of the hip. Through these incisions, instruments are inserted which allow for precise tasks like shaving, cutting, grasping, passing sutures (stitches), and trying knots. These instruments allow for a range of procedures to be done, including smoothing off torn cartilage, trimming bone spurs, and removing inflamed tissue.
Following the procedure, local anaesthetic is injected into the hip and wound.
Upon completion, the arthroscopic incisions are usually sutured and then bandaged with adhesive tapes, and the hip is dressed with protective dressings. Depending on the surgeon’s findings and the extent of repair needed, the duration of the procedure may vary.
Dressings: The incisions will be closed with absorbable cosmetic sutures and covered by a waterproof dressing. These dressings will remain intact for 7-10 days and will be changed by a nurse during the first post-operative review. It is essential to keep the wounds dry. Showering is advisable, using warm water and soap gently on the wound, and then drying the area very well.
Pain and swelling: The hip and groin area may be painful, and each patient may experience different levels of discomfort, but there should not be any severe pain. The patient will be prescribed analgesia (pain relief medication) and anti-inflammatory medication upon discharge from the hospital. It’s important to take these medications as prescribed and not wait for the pain to become severe. Some numbness in the groin or thigh due to position during surgery is normal and should resolve during recovery. Ice therapy around the incisions and groin (a maximum of 15 minutes per hour) during the first week will help with the inflammation. After one week, it’s best to keep the wound warm.
Mobilising: Once patients recover from anaesthesia, they will be mobile, ability to bear weight will be guided by the extent of repairs performed. Even if full weight-bearing is possible, crutches may be needed initially for support and safety. Some limping is expected for the first few weeks, but patients will notice a significant improvement in their gait over time.
Exercise: Patients can begin gentle exercise within a few days of surgery. Hydrotherapy can commence after the wounds have been checked. Non-impact exercises with a physiotherapist can start within 7-10 days. Patients should avoid deep flexion of the hip and use an exercise bike with the seat raised high. Physiotherapy will help improve the range of motion, proprioception, strength, control, and stability of the hip.
Exercise precautions: Patients should avoid deep flexion and any impact activities, such as running, for at least six weeks.
If patients are worried about their level of pain, experience significant bleeding, or notice fever or redness around the surgical site, they should contact the office immediately. If assistance is needed after hours, patients can contact the hospital where the surgery was performed, and they will contact Professor Al Muderis on their behalf.
Norwest Private Hospital: (02) 8882 8882
Macquarie University Hospital: (02) 9812 3000
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Professor Munjed Al Muderis is an orthopaedic surgeon and a clinical professor at Macquarie University and The Australian School Of Advanced Medicine. He specialises in hip, knee, trauma and osseointegration surgery. He is a fellow of the Royal Australasian College of Surgeons and Chairman of the Osseointegration Group of Australia.