Hip Arthroscopy - Orthopaedics 360

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Hip Arthroscopy

A minimally invasive technique

Written by Dr Chien-Wen Liew

You kicked, twisted, fell and felt something bad happen in your hip (groin). What now?

This guide is to help you learn more about hip arthroscopy, some of the conditions that might require a hip arthroscopy, and how it is performed. Is it right for you?

Before Hip Arthroscopic surgery, small injuries to the hip were either left, or required a large incision with a cut of the bone, and dislocating the hip to view all of the areas of the hip. Hip Arthroscopy has essentially revolutionised this, by allowed patients to undergo a much less invasive procedure to view most of the hip joint. Its use is increasingly relevant in more complex conditions of the hip as advances in equipment and techniques become available.

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Hip Labral Tear

A Hip Labral tear is a relatively common sporting injury, especially for high performance athletes such as football players, netball players and dancers. The high hip flexion and twisting movements can injury the labrum. The labrum is a soft tissue structure that creates a rim around the acetabulum (cup). When torn, there is groin pain which stops an athlete from continuing to play. Labral tears rarely heal themselves.

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What is Femoroacetabular Impingement

More advanced understanding exists about Femoroacetabular impingement and how it relates to the development of labral tears and hip osteoarthritis. A “Cam and Pincer” lesion is the usual cause, and results in a reduction in hip joint movements, pain, or even can predispose someone to suffering a hip labral tear.

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Non Operative Management

Not all labral injuries or FAI (femoroacetabular impingement) need an operation.

A hip labral tear may have been present for a long time prior to symptoms starting. Often the pain comes from associated inflammation of the joint, and this results in pain and limitations in joint movements. When a labral tear is confirmed (an MRI is required to confirm the diagnosis), then the treatment may consist of simple analgesia, anti-inflammatories, and stopping high level sporting activities for a period of time (usually 4-6 weeks). A steroid injection may be used to diagnose as well as treat the inflammation in the hip. This is done under ultrasound guidance.