What is a hip arthroscopy?
Hip arthroscopy is keyhole surgery to the hip joint. It is performed under an anaesthetic and involves two or three 1cm cuts made at the side of the hip and inserting a small camera and instruments into the hip to perform surgery inside the joint. Hip arthroscopy can be used to treat labral tears, hip impingement, loose fragments within the hip torn ligaments within the hip, and other conditions. It also gives diagnostic information about the state of the joint.
Who needs a hip arthroscopy and how effective is it?
Hip arthroscopy is effective for treating tears, loose flaps and impingement. It is not as effective for treating hip arthritis, and it won’t fix muscle pain or pain coming from the back. The most important factor in whether arthroscopy will be effective is to check that there is no arthritis (or at most, mild arthritis) and that the pain is coming from the hip joint, not the back or the muscles around the hip. Provided that this is the case, hip arthroscopy is effective in significantly improving pain in about 80% of patients.
How is a hip arthroscopy performed?
Hip arthroscopy is usually performed under a general anaesthetic (completely asleep). The leg is stretched out using a traction operating table, so that a gap opens up between the ball and socket of the hip. Using x-rays, a needle and then a telescope are inserted into the hip through a 1cm cut. A second (and sometimes 3rd) 1cm cut is made and a needle and then instruments inserted into the hip through these. The labral tear and impingement are repaired or removed. Local anaesthetic is put in to numb the hip and a stich is put into each cut. The whole procedure may take up to 90 minutes or longer if there is a lot of damage to fix.
How long will I be in hospital for?
While a hip arthroscopy takes about 90 minutes to do you will need to come into hospital 1-2 hours early to be checked in and sort out your paperwork. After the operation you will need to be observed for a couple of hours to ensure that you have recovered from the anaesthetic. It is possible to be discharged from hospital on the same day as your surgery, but most patients stay one night in hospital.
What do I do with my wound dressings?
The dressings are waterproof. They should stay on, and the stitches should remain in place until your two-week review appointment. During arthroscopy, a lot of fluid is pumped into the hip joint. It is quite common for some fluid to leak from the dressing over the first three days after surgery. You will be given spare dressings in case the original ones peel off. Just dab the skin dry and put the new dressing on. Don’t clean it or apply antiseptic. If the wound leaks five or more days after surgery you should call Melbourne Hip and Knee.
How long is the recovery?
Recovery is slower than for a knee arthroscopy. Although the cuts on the skin are only 1cm, there is a lot more work deep inside the joint, and this takes time to recover. You will be on crutches for the first few days, and a single crutch for a couple of weeks. The details vary, and may be slower, depending on what repair needs to be done. Return to pain free full contact sport or full manual labour may be 3-6 months. If the arthroscopy is just cleaning up loose flaps or tear, then the recovery may be much quicker; you will need to talk to your surgeon about your own hip.
What exercises do I need to do after a hip arthroscopy?
A full physiotherapy program is a vital part of recovery from hip arthroscopy. This starts with a specialist physiotherapist in hospital who will then tailor your program and either see you again as an outpatient or refer you back to your own physiotherapist with recommendations based on what is done in surgery.