What Is Hip Arthroscopy and What Conditions Does It Treat?

Your hips play an important role in navigating the world. Simple tasks like walking or bending over can become almost impossible if you experience hip pain or a reduced range of motion. 

At Alexander Orthopaedic Associates, we look for minimally invasive ways to treat hip problems found in all types of patients. If we can fix your hip without major surgery, we will do our best to make it happen. One of the ways we treat hip issues is with hip arthroscopy.

What Is Hip Arthroscopy?

Hip arthroscopy is a common outpatient surgical procedure performed to diagnose and treat hip problems. An orthopedic surgeon makes a small incision near the hip and inserts a device called an arthroscope, which contains a small camera. The camera allows the surgeon to view the hip joint directly to diagnose any injuries, damage, or inflammation. In many cases, the surgeon will make two additional small incisions to insert small surgical instruments that are used to treat and repair the source of the problem.

Hip arthroscopy is a common technique to treat pain and inflammation caused by various conditions. An arthroscopy lets your doctor view the hip joint directly: this lets them confirm their diagnosis and formulate a better plan for treatment. If a patient hasn’t responded to non-surgical treatments like rest, physical therapy, or anti-inflammatory injections, a doctor may recommend an arthroscopy to address the problem directly.

Is Hip Arthroscopy a Major Surgery? 

Hip arthroscopy is rarely considered major surgery. It’s typically a minimally invasive outpatient procedure. The whole process often takes less than two hours and only involves two or three roughly half-inch incisions in the skin. Patients can bear weight on their hips within a few weeks.

Because arthroscopy isn’t invasive, it is often successful in treating patients' hip issues. While it’s a step above non-surgical treatment, it typically involves lower levels of pain and lower rates of infection than major surgery.

What Are the Advantages of Hip Arthroscopy?

A hip arthroscopy might seem intimidating at first; however, there are several benefits to this procedure that contribute to positive patient experiences. A few advantages of hip arthroscopy include: 

• Less tissue damage: The instruments used in a hip arthroscopy are small and thin, which means doctors can create smaller incisions and cut into less tissue.
• Less pain and scarring: Smaller incision sites and less tissue damage means patients typically experience less pain after the procedure. There is also likely to be less scarring, and the opportunity for infection is limited.  
• Quicker recovery: Patients who receive a hip arthroscopy may notice a quicker recovery time compared to more invasive hip surgeries. While every patient recovers on their own time and needs different care to bounce back, most people who undergo hip arthroscopy can recover faster than during other surgical procedures. 

Hip arthroscopy’s main advantage over non-surgical options is that it gives your doctors the opportunity to fully understand what is wrong with your hip and how to treat it. Your doctor should be able to treat the issue during surgery or create a plan of action to reduce your pain and increase your hip mobility moving forward.

When Is a Hip Arthroscopy Recommended?

Not only is a hip arthroscopy favored by patients as a less-invasive option, but it is also a flexible procedure that can address a variety of problems. Your physician may consider hip arthroscopy to treat the following conditions: 

Osteoarthritis

Hip osteoarthritis is a degenerative disease that occurs when there is inflammation or damage to a joint's cartilage. This is a condition often seen in older patients who experience pain, swelling, and limited mobility. 

Labral Tears

Labral tears often occur alongside a femoroacetabular Impingement. The cartilage that surrounds the hip socket can tear or become inflamed, limiting physical activity and causing pain. Physicians will use hip arthroscopy to either mend the tear or remove the inflamed labral tissue to reduce pain. 

Femoroacetabular Impingement 

This occurs when the femoral head rubs against the acetabulum – part of your hip socket. It is a condition often seen in active patients who experience movement-related groin pain. Patients may also notice a limited range of motion or a clicking or popping sensation when they move. 

Bursitis

Bursitis occurs when there is inflammation and swelling of the bursae, or the fluid-filled sacs that lubricate the joints. Patients who experience hip bursitis may notice pain in the hip and outside thigh, which can be aggravated by simple movements like walking or moving around. 

Snapping Hip Syndrome

Snapping hip syndrome is also known as iliopsoas tendinitis or “dancer’s hip. Patients often complain of a snapping or popping sensation when the hip is flexed. It's caused by repetitive, physically demanding movement such as dance, strength-training, tennis, and other sports. 

Dysplasia

Dysplasia occurs when the hip joint is abnormally shallow, meaning it has a harder time holding the femoral head in place. Hip dysplasia may cause more labral tears because it puts increased stress on the tissue.

Synovitis

Synovitis refers to inflammation in the joint lining, or the synovial membrane. The hip may become swollen and sensitive to the touch, limiting a patient’s ability to move around comfortably. 

Additionally, hip arthroscopy can be used to remove any loose bodies around the hip joint. These can include bits of cartilage and bone that become loose and move around the joint, causing pain, inflammation, and damage. This procedure can also be used to stop a hip infection from worsening and possibly causing permanent damage. 

Hip Arthroscopy Procedure: The Basics

Understanding the basics of hip arthroscopy can help you better prepare for the procedure and the recovery. The first thing you need to know is the length of the surgery: while every patient is different, most hip arthroscopy surgeries take between 30 minutes to two hours to complete. Ask your doctor to estimate how long the procedure will take. They should be able to give you a window of time so you can prepare.

Hip arthroscopy is usually considered an outpatient procedure, which means you will return home on the same day. Patients are given anesthesia to reduce any pain, either in the form of general anesthesia (gas which puts you to sleep) or regional anesthesia, which uses an injection to numb you from the waist down.

Once you are ready for surgery, the doctor will then position you comfortably with the leg put in traction – or with the hip pulled away from the socket. This allows the surgeon to make incisions and insert instruments into your hips easily.   

Most hip arthroscopy procedures only require two or three half-inch long incisions. One incision will be for the arthroscope, which allows the physician to have a clear view of the hip. The view of the arthroscope will be projected on a screen, allowing your surgeon to see what they are doing throughout the process. Other instruments will then be inserted through the second and third incisions to treat any identifiable problems. 

When the doctor’s work is complete, they will withdraw the instruments and close the incisions with stitches or skin tape. The final step is to apply an absorbent dressing to prevent any further bleeding.   

How Long Is Recovery After Hip Arthroscopy?

Most hip arthroscopy patients regain full mobility within eight weeks of surgery. That being said, every patient and procedure is different. It may take up to six months to fully recover from the arthroscopy. Additionally, your doctor may recommend physical therapy to help you increase your range of motion.

How Painful Is a Hip Arthroscopy?

The severity of the pain and how long it lasts after surgery depends on the type of procedure you had. In the days and weeks following hip arthroscopy, you may notice pain in your hip, lower back, buttocks, knees, and ankles. Your doctor may prescribe a pain medication to help you during this recovery period.

While it will take a few days for the swelling from the surgery to go down, you should keep an eye on the wound to make sure it doesn’t get infected. Signs of infection include increased pain, sensitivity, swelling, and discoloration. If you notice any of these signs, return to your doctor for treatment.

Can You Walk after a Hip Arthroscopy?

When you leave the physician’s care following surgery, you may be given crutches to improve your short-term mobility. Some patients only need to use crutches for a few days until they feel comfortable bearing weight on their hips. However, other patients will need to use crutches for several weeks as they recover. Your doctor will tell you how long they recommend using them and when you can start to walk on your own.   

How Do You Go to the Bathroom after a Hip Arthroscopy?

Early on in your recovery, sitting on a toilet or on any chair where your legs are flexed at a 90 degree angle or more can be very uncomfortable. If the toilet seat in your home is low, you may have difficulty getting up or down. Sitting on an elevated toilet or getting a riser for your toilet seat will help alleviate the discomfort.

Do You Have to Wear a Brace after a Hip Arthroscopy?

While every case is different, most patients have to wear a brace on their hip for about three weeks after a hip arthroscopy. A brace helps keep the hip joint stable as it heals to reduce pain and protect the patient from making any excessive movements that could disrupt the surgical repairs. Some braces are designed to keep your hip in a specific position to promote optimal healing. Your doctor will discuss the specifics with you about whether you’ll need a brace and for how long.

What Activities Should You Avoid after a Hip Arthroscopy?

As your pain decreases and your range of motion improves following your hip arthroscopy, you may be tempted to resume normal levels of activity. However, there are some things you should be careful about doing and avoid doing entirely when possible. These include prolonged standing or walking, heavy lifting, squatting, and sleeping on your side.

If you had a minimally-invasive treatment, then you may be able to drive yourself short distances within a few days after your surgery. However, most doctors will recommend only driving vehicles with automatic transmissions. You may not be able to use the clutch in a manual car for several weeks after the procedure.

If you do find yourself driving after surgery or riding in a car for long periods of time, tilt your seat back so you are sitting at 120 degrees. You should do the same for all seating in the weeks following your hip arthroscopy. Sitting upright at a 90-degree angle can place extra stress on your hips. Try to lean back whenever possible and keep your hip cushioned.

Choosing a Surgeon For Your Hip Arthroscopy

As a patient, your comfort should be the top priority of every physician you work with. Not only should you receive the top treatment that allows for a rapid recovery, but you should feel safe and heard throughout the entire arthroscopic process.

At Alexander Orthopaedics, our patients receive world-class care from the moment they walk through the door. Our team of physicians, physician’s assistants, and physical therapists is here to help you with the surgery and recovery process, standing by your side all the way through to the last follow-up appointment. Our expert physicians use industry-leading equipment to give you the best chance at a full recovery. This is the Alexander Outpatient Advantage.

Don’t let persistent hip pain reduce your mobility. Schedule an appointment today to learn more about arthroscopy and other hip procedures and surgeries we offer.