Hip Arthroscopy

Arthroscopy is now the gold standard for Knee, Shoulder Wrist Elbow and Ankle surgery. It is now being increasingly used both for surgery in and around Hip. It is also effective as a day case treatment of most conditions around the young adult hip and the elite sportsman.

Within the discipline of sports medicine, the hip has received considerably less attention than other joints, largely because of the difficulty that practitioners have traditionally had in assessing intra articular abnormalities around the hip. Over the past few years, hip arthroscopy has been gaining considerable interest. The advent of better diagnostic tools, especially MRI, has helped in the detection of hip Labral tears in a more predictable fashion. New techniques and instrumentation have facilitated the treatment of Labral tears by hip arthroscopy. Most notably, the recent adaptation of arthroscopy instruments specifically designed for the hip has led to improved safety, visualization, and accessibility of this joint.

Athletes subject their bodies to extreme forces; their lower extremity joint may experience joint reactive forces in excess of five times body weight during activities such as running and jumping. The mechanisms of injuries can be from repetitive motion or direct trauma.

The hip joint is the largest ball and socket joint in the body and goes through seven million movement cycles per year in the average person. The hip joint can be prone to wear and tear and arthritis in older individuals. However, younger people can also develop a variety of hip joint problems that can affect walking, running, sport and daily activities.

Advances in technology and an increased awareness of pathology have allowed us to investigate and image problems of the hip joint with a new degree of accuracy. Scans such as MRI-arthrograms can show tears of the cartilage within the hip joint clearly.

The word ‘arthroscopy’ means literally ‘looking into the joint’. Knee arthroscopy was first introduced into the UK in the 1970s and is now one of the most commonly performed orthopaedic operations. Arthroscopy of the hip joint is a much newer procedure due to the added technical complexities, and is currently only being performed by relatively few orthopaedic surgeons.

Problems in the hip joint that can potentially be treated by arthroscopic surgery of the hip include:

  • Snapping ITB
  • Tight Psoas
  • Gluteal Medius Tears
  • Piriformis problems
  • Loose bodies (loose bits of cartilage floating around inside the joint)
  • Labral tears (tears of the rim of cartilage surrounding the socket)
  • Chondral damage (wear and tear of the layer of cartilage covering the bone)
  • Femoro-acetabular impingement (extra lumps of bone catching and rubbing in the joint)
  • Trochanteric Bursitis

There is a wide variety of different symptoms that these pathologies in the hip joint may cause, including:

  • Pain in the hip (often felt in the groin)
  • Clicking within the joint
  • Giving way (where the leg just ‘gives out’)
  • Discomfort when moving the hip into certain positions (especially lifting the knee up and rotating the leg inwards)
  • Stiffness of the joint
  • Difficulty walking or running