Hip Arthroscopy / "Hip Preservation Surgery"
What are the indications of the procedure?
Hip arthroscopy is typically indicated for early arthritic conditions of the hip, so- called Hip Impingement, sporting injuries resulting in hip labral tears, loose bodies in the hip, hip inflammation (“hip synovitis”), or psoas tendinopathy resistant to other non-operative treatment. Whether of not hip arthroscopy can help in patients with moderate hip arthritis is the subject of ongoing research.
What does the above entail?
Hip Arthroscopy is a key-hole procedure, which is performed under General Anaesthetic or Epidural Anaesthesia with sedation. You are placed in a traction table which allows safe and controlled distraction of the hip joint. This facilitates examination of the hip joint safely, visualising the cartilage surfaces. The soft cartilage ‘labrum’ is examined and probed. Tears are repaired using ‘anchor sutures which are drilled into the socket safely and under direct vision. Excess bone causing hip impingement is carefully and slowly trimmed. Careful assessment during the procedure ensures that adequate but not too much bone is removed.
Length of Stay for hip arthroscopy
Overnight stay to facilitate physiotherapy treatment, including massage, safe mobility with crutches (usually 3 weeks, may be shorter or longer) and to ensure pain levels are controlled.
Time off work
Typically 3-4 weeks. More than anything else it allows optimal rehab and exercise under the expert supervision of physio colleagues.
Typical recovery time
4 phases of recovery- from partial weight bearing to sport specific physiotherapy takes on average 3-4 months to achieve, and varies according to the underlying diagnosis, and time from presentation to surgery.
Risks of surgery
Infection, numbness due to compression or stretching of nerve fibres, stiffness, clots (thrombosis), a small chance in patients with arthritis of persistent symptoms/progression of OA (5% risk quoted).
Hip Replacement Surgery
What does this involve?
An operation under spinal/epidural anaesthesia with sedation, incision around your hip, replacement of the arthritic hip with a patient specific implant, length of stay typically 3 nights.
Usually significant improvement in pain, function, quality of life and mobility. Risks include infection, clots (thrombosis), dislocation, leg length difference ), revision because of subsequent wear and loosening and a smallmortality risk. Various measures are put in place (injections, stockings, etc) to reduce the risks of the above.
Time to full recovery
Variable, may be very quick in some patients, in others 6-9 months before the full benefit of the procedure is experienced.