HIP ARTHROSCOPY
HIP ARTHROSCOPY
Hip injuries are extremely common in sports and recreation and can be due
to a specific injury or may develop over time due to repetition. When
a hip injury affects athletic performance, arthroscopic intervention may
assist in a person’s return to full strength. In fact, there are
even many elite athletes who have benefited from hip arthroscopy.
We spoke with Dr. David Gazzaniga, a sports medicine specialist at NOI,
to learn more about hip arthroscopy. Dr. Gazzaniga has previously served
as the team doctor for the New York Jets and the head orthopedic surgeon
for the New York Islanders and Hofstra University.
What is hip arthroscopy?
Dr. Gazzaniga: Hip arthroscopy is very similar to arthroscopic surgery of other joints.
A camera is placed through a small incision into the joints to evaluate
and treat injuries. However, arthroscopic surgery of the hip is different
than in other joints because of how deep the joint is to the surface and
it is a more confined joint space because of its architecture as a ball
and socket joint.
What conditions can be treated with a hip arthroscopy?
Dr. Gazzaniga: There are a few conditions that do well with arthroscopy of the hip joint.
Much of this revolves around a condition called femoroacetabluar impingement.
This can occur due to the shape of the joint, sometimes the bones do not
fit perfectly together causing the hip bones to rub, or because of a specialized
type of activity or both. This condition typically occurs in conjunction
with a tear to the acetabulum. The pain associated with this condition
is pain in the groin area, although the pain sometimes may be more toward
the outside of the hip. Sharp stabbing pain may occur with turning, twisting
and squatting, but sometimes it is just a dull ache.
Also, a patient may have some instability in their hip and may benefit
from treatment to tighten the capsule of the joint, which can be done
arthroscopically as well.
Finally, a small category of people may benefit from arthroscopy to treat
problems around the hip joint like muscle tears, similar to a rotator
cuff repair.
Despite our best efforts, the surgery has shown to be unsuccessful for
those who have arthritis in their hip joint.
Who might be a good candidate for hip arthroscopy?
Dr. Gazzaniga: Good candidates are people with pain and pinching that have a labrum
tear with no arthritis. These people obviously tend to be a younger, more
athletic group. If the patient has arthritis then there should be a very
special circumstance to consider going forward with arthroscopic surgery.
What are the advantages of hip arthroscopic surgery?
Dr. Gazzaniga: There are places around the world that are doing this surgery open for
similar problems but the advantage of arthroscopy is to spare soft tissue
trauma, which can mean less pain and a faster recovery than open surgery.
The other advantage is that in many ways the visualization is better arthroscopically
because you can see portions of the hip joint that are very difficult
to view during an open procedure.
How long does the procedure take?
Dr. Gazzaniga: A typical arthroscopy to repair a labrum and trim the bone on the rim
and the femur takes about 90 minutes.
Typically, how long is the recovery process?
Dr. Gazzaniga: Unfortunately comparing a hip arthroscopy to a knee arthroscopy the process
takes much longer to recover. A person can return to sports from a simple
knee arthroscopy within a few weeks but from a hip scope it can take 3-6 months.
How long before patients can return to an active lifestyle?
Dr. Gazzaniga: Usually I allow them to attempt jogging at about 3 months and full sports
at 5-6 months depending on the sport.