Hip Arthroscopy
Mr Malik is one of the few orthopaedic surgeons in the country who regularly performs hip arthroscopy.
Schematic of Hip Keyhole Surgery
Hip arthroscopy is not widely performed and is a more involved procedure than many other forms of arthroscopy.
Labral tear as seen during surgery
The indications for this technique are still being developed, but it offers hope for the large number of people who suffer from hip or groin problems who in the past may have been told to ‘just get on with it as nothing can be done’.
DiagnosisA large number of hip conditions that can be treated with hip arthroscopy present with either groin pain, buttock or thigh pain and occasionally with catching or snapping in the hip which can be painful. Often patients have consulted many different doctors before referral is forthcoming. A MRI arthrogram of the hip is used to investigate these problems.
Patients with the following problems can benefit from hip arthroscopy:Labral Tear
The labrum of the hip is a lip of thick cartilage that runs around the edge of the hip socket. When a labral tear of the hip occurs, the torn tissue can become pinched in the joint causing pain and catching sensations. Labral tears can occur from acute injuries such as sport or as a chronic problem due to impingement of the hip.Hip impingement
Impingement of the hip is when the shape of the hip bones causes repetitive injury to the labrum and the cartilage lining the joint. This results in hip pain and may be one of the factors that lead to arthritis. Treatment involved reshaping of the bones inside the hip. Sometimes cartilage within the hip is also affected and this can be treated at the same time.
Loose Bodies
Loose bodies are pieces of cartilage that form within the joint. They look like small marbles floating within the joint space. These loose bodies can become caught within the hip during movements.
Snapping Hip Syndrome
Snapping hip syndrome has several causes, some of which can be treated with hip arthroscopy. If something is catching within the hip joint, hip arthroscopy can be used to relieve this snapping. Also, hip arthroscopy can be used to perform a psoas tendon release in cases of internal snapping hip syndrome.
Rehabilitation after hip arthroscopy
In the first few weeks after surgery, patients are often instructed to keep some weight off the hip, particularly if the bone has been reshaped. Work on regaining motion around the joint, and gentle strengthening exercises start early on. Typically, patients work with a physiotherapist for advice with exercises and stretches.
Most patients can begin light activities (cycling, swimming) within a few weeks. Athletes most often take about 12 weeks to start more rigorous training. Full recovery can take 6 months and is dependent of the duration of symptoms before surgery.
Overviews of Hip Arthroscopy: