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Hip

Hip Arthroscopy

What is hip arthroscopy?

Hip arthroscopy is a minimally invasive surgery performed using general anesthesia. A camera, called an arthroscope, is used to diagnose and treat the causes of hip pain and dysfunction.

The arthroscope is a small, pencil-sized instrument with a light source and a camera. It is inserted into the hip joint through a small keyhole incision. The camera transmits images from inside the hip to a video monitor, allowing the surgeon to see the hip’s structures in great detail. Other small incisions are made to insert surgical instruments and perform the needed repairs.

Because the incisions are small, there is less pain and joint stiffness, which speeds recovery. This surgery is done as an outpatient. Complete recovery, including a return to full sports and impact activity, can take around six months.

Hip arthroscopy is recommended to relieve hip pain and dysfunction due to femoroacetabular impingement (FAI) and labral tears when conservative treatments such as physical therapy, medications, and rest have failed to improve symptoms.

FAI is a condition where excess bone develops on the ball (femoral head) or in cases where the socket (called the acetabulum) is extra deep, causing abnormal contact between the hip ball and socket, resulting in hip pain and limited motion. Hip arthroscopy can reshape and remove excess bone on the ball or socket to reestablish a round ball and a normally shaped socket to alleviate the impingement. Surgical reshaping of the hip bones is called osteochondroplasty.

The labrum is a ring of cartilage that surrounds the hip joint, providing stability and cushioning. Labral tears commonly occur as a result of longstanding bony impingement in FAI. Less commonly, labral tears can result from injury such as a hip dislocation. Labral tears generally do not heal independently, though many patients can have labral tears without symptoms. If your surgeon determines that the labral tear is causing your hip pain, hip arthroscopy can be used to repair the torn labrum. The torn labrum is typically repaired with suture anchors during hip arthroscopy at the same time as osteochondroplasty.

Hip arthroscopy with labral repair and osteochondroplasty is a joint-preserving treatment with excellent outcomes. Around 85% of patients return to their sports around 6 months after surgery. Outcomes are best in patients who do not have evidence of hip osteoarthritis or cartilage damage. When you or a loved one experiences hip pain, it is important to seek professional care.

The UCSF Women’s Sports Medicine Center supports female athletes of all ages and abilities, from the recreational to the elite athlete, with a team of sports medicine and orthopedic specialists. We are proud to offer comprehensive, compassionate, and evidence-based care. Contact us to schedule a consultation to learn more.

References

  • https://orthoinfo.aaos.org/en/diseases–conditions/femoroacetabular-impingement/
  • Hugenberg G, Stallons J, Smith C, et al. Clinical Commentary: A Criteria-Based Testing Protocol for Return to Sport Post Hip Arthroscopy for Impingement. IJSPT. 2023;18(5):1218-1229. doi:10.26603/001c.87629
  • Lee SM, Kim JS, Moon NH, Woo SH, Park C, Shin WC. Recovery After Hip Arthroscopy in Patients With Combined Femoroacetabular Impingement and Labral Tears Compared With Isolated Pathology. Orthop J Sports Med. 2023 Jun 19;11(6):23259671231167908. doi: 10.1177/23259671231167908. PMID: 37359977; PMCID: PMC10286186.
  • Palmer AJR, Ayyar Gupta V, Fernquest S, et al. Arthroscopic hip surgery compared with physiotherapy and activity modification for treating symptomatic femoroacetabular impingement: multicentre randomized controlled trial [published correction appears in BMJ. 2021 Jan 18;372:m3715]. BMJ. 2019;364:l185. Published 2019 Feb 7. doi:10.1136/bmj.l185
  • Domb BG, Annin S, Monahan PF, Lee MS, Jimenez AE, Maldonado DR. Ten-Year Survivorship, Outcomes, and Sports Participation in Athletes After Primary Hip Arthroscopy for Femoroacetabular Impingement Syndrome. Am J Sports Med. 2023;51(9):2383-2395. doi:10.1177/03635465231180305
  • Ramkumar PN, Olsen RJ, Shaikh HJF, Nawabi DH, Kelly BT. Modern Hip Arthroscopy for FAIS May Delay the Natural History of Osteoarthritis in 25% of Patients: A 12-Year Follow-up Analysis. The American Journal of Sports Medicine. 2024;52(5):1137-1143. doi:10.1177/03635465241232154
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