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What is Hip Endoscopy?

Hip endoscopy is a minimally invasive surgical procedure used to treat various hip joint problems. This may include repairing damaged cartilage, removing loose bodies, addressing impingements, or treating conditions like labral tears. The main objective of hip endoscopy is to relieve chronic debilitating hip pain as a result of these conditions.

The hip joint is one of the largest weight-bearing joints in the body, formed by the thighbone (femur) and the acetabulum of the pelvis. It is a ball and socket joint with the head of the femur as the ball and the pelvic acetabulum forming the socket. The area outside of the hip joint is called the "peritrochanteric space." Located in this space are soft-tissue structures such as the trochanteric bursa, gluteus medius/minimus, and iliotibial band that help stabilize and move the joint.

During hip endoscopy, your surgeon inserts a thin tubular instrument with a powerful light and a tiny camera at the end called an endoscope into the hip joint through small incisions. The endoscope allows the surgeon to visualize the interior of the hip joint on a monitor in real-time and perform the required repair.

Indications for Hip Endoscopy

Common conditions that may be addressed through hip endoscopy include labral tears, femoroacetabular impingement (FAI), hip joint infections, loose bodies within the joint, trochanteric bursitis, external snapping hip syndrome, internal snapping hip syndrome, and synovitis (inflammation of the joint lining).

Preparation for Hip Endoscopy

In general, preparation for hip endoscopy may involve the following steps:

  • A comprehensive medical evaluation, routine blood tests, and imaging studies
  • Informing your doctor of any allergies to medications, anesthesia, or latex
  • Provide your physician with a list of medications or supplements you are taking
  • You may need to adjust or temporarily stop taking certain medications - especially those that can affect blood clotting
  • Disclosing any recent illnesses or other medical conditions you may have
  • Stopping smoking, as it can impact the healing process and increase the risk of complications
  • Abstaining from food or drink for at least 8 hours prior to the surgery
  • Signing an informed consent form

Procedure for Hip Endoscopy

In general, the procedure for hip endoscopy may involve the following steps:

  • You will be administered general or regional anesthesia to ensure you are pain-free during the surgery.
  • Your surgeon makes small incisions (usually 2-4) around the hip joint. These incisions are typically less than one centimeter in size.
  • Through these incisions, the surgeon introduces specialized instruments, including the endoscope.
  • An endoscope is inserted through one of the incisions and allows the surgeon to visualize the inside of the hip joint on a monitor.
  • The surgeon inspects various structures within the hip joint, including the acetabulum (socket), femoral head (ball), labrum, cartilage, and synovium.
  • The endoscope enables the surgeon to identify any abnormalities, such as tears, inflammation, impingements, or loose bodies.
  • Based on the findings, the surgeon may perform various procedures to address the identified issues. This may include repairing labral tears, removing loose bodies, reshaping a bone to address impingements, the release of the iliopsoas tendon, or other interventions.
  • Specialized instruments are used through the additional incisions to perform these procedures.
  • Once the necessary repairs or treatments are completed, the instruments are removed, and the incisions are closed.

Postoperative Care and  Recovery

After surgery, you will be transferred to the recovery area where you will rest until you are discharged. You will receive pain relief medications as needed. Antibiotics may also be prescribed to address the risk of surgery-related infection. Compression stockings and early mobilization are usually recommended to reduce this risk of blood clot formation. You will be able to do light activities within a couple of weeks. You will also be given postoperative advice and instructions on the following:

  • The use of assistive devices for walking, such as a cane or crutches
  • Limited weight-bearing activities
  • Suture and dressing care
  • Strict adherence to physical therapy and exercise regimen to help the patient regain strength, flexibility, and function in the hip
  • Dietary changes and supplements to improve bone health
  • Adherence to prescribed medications
  • Adherence to follow-up appointments to monitor your progress

Benefits of Hip Endoscopy

Some of the benefits of hip endoscopy include:

  • Minimal muscle trauma
  • Reduced blood loss
  • Quicker recovery
  • Shorter hospitalization
  • Reduced risk of infection
  • Preservation of healthy tissue
  • Improved range of motion with less post-operative pain

Risks and Complications

Some of the risks and complications associated with hip endoscopy include:

  • Infection
  • Bleeding
  • Nerve or vascular injury
  • Persistent pain or discomfort
  • Adverse reactions to anesthesia
  • Allergic reactions
  • Blood clot formation (deep vein thrombosis)