Our Summary

This research paper discusses the increase in diagnoses and treatments of patients with femoroacetabular impingement, a condition where the hip bones are abnormally shaped and cause damage to the joint. This has led to a rise in hip arthroscopies, a type of minimally invasive surgery. Though this procedure usually provides significant relief from pain and improved function, there is a growing number of patients who continue to experience pain after surgery. The reasons for this are complex and can include factors related to the patient, the surgeon, and the post-surgery physical therapy. The paper discusses common reasons for these unsuccessful surgeries, such as remaining bone deformities and issues with the capsule surrounding the joint, and provides suggestions for diagnosis and treatment of these cases.

FAQs

  1. What is femoroacetabular impingement and how is it diagnosed?
  2. What is a hip arthroscopy and why has there been an increase in this type of surgery?
  3. What are some reasons why a patient may continue to experience pain after a hip arthroscopy?

Doctor’s Tip

One helpful tip a doctor might tell a patient about arthroscopy is to follow the recommended post-surgery physical therapy plan closely. This is important for ensuring proper healing and rehabilitation of the joint after the procedure. It is also important to communicate any persistent pain or discomfort to your doctor, as this could indicate underlying issues that may need further treatment. Additionally, maintaining a healthy lifestyle and weight can help improve the success of the surgery and reduce the risk of complications.

Suitable For

Patients who are typically recommended for arthroscopy include those with:

  1. Femoroacetabular impingement
  2. Meniscal tears in the knee
  3. Ligament tears in the knee (such as ACL tears)
  4. Cartilage damage in the knee
  5. Loose bodies in the joint
  6. Rotator cuff tears in the shoulder
  7. Labral tears in the shoulder or hip
  8. Synovitis (inflammation of the joint lining)
  9. Osteoarthritis in the joint
  10. Infections in the joint

It is important for patients to undergo a thorough evaluation by a healthcare professional to determine if they are suitable candidates for arthroscopy. Additionally, patients should be informed of the potential risks and benefits of the procedure and have realistic expectations for their recovery and outcomes.

Timeline

Before arthroscopy:

  1. Patient experiences hip pain and limited range of motion.
  2. Patient undergoes physical examination, imaging tests such as X-rays or MRI, and possibly a diagnostic injection to confirm the diagnosis of femoroacetabular impingement.
  3. Surgeon recommends hip arthroscopy as a treatment option.
  4. Patient undergoes pre-operative evaluation and preparation for surgery.

After arthroscopy:

  1. Patient undergoes hip arthroscopy procedure to correct bone abnormalities and damage to the joint.
  2. Patient is monitored in the recovery room and discharged home the same day or after a short hospital stay.
  3. Patient begins post-operative physical therapy to restore hip function and strength.
  4. Patient gradually resumes normal activities and sports, following the guidance of the surgeon and physical therapist.
  5. Patient experiences relief from hip pain and improved function in the majority of cases.
  6. In some cases, patients may continue to experience pain or limited range of motion after surgery, requiring further evaluation and treatment.

What to Ask Your Doctor

  1. What are the reasons for my hip pain and how can arthroscopy help alleviate it?
  2. What are the potential risks and complications associated with hip arthroscopy?
  3. What is the success rate of hip arthroscopy in patients with femoroacetabular impingement?
  4. What is the recovery process like after hip arthroscopy and what can I expect in terms of pain and mobility?
  5. Are there any alternative treatments to consider before undergoing hip arthroscopy?
  6. How many hip arthroscopy procedures have you performed and what is your success rate?
  7. What are the potential reasons for continued pain after hip arthroscopy and how can they be addressed?
  8. What are the long-term outcomes of hip arthroscopy for patients with femoroacetabular impingement?
  9. Will I need physical therapy after hip arthroscopy and what will that entail?
  10. How can I prevent future hip issues after undergoing hip arthroscopy?

Reference

Authors: Makhni EC, Ramkumar PN, Cvetanovich G, Nho SJ. Journal: J Am Acad Orthop Surg. 2020 Jul 1;28(13):538-545. doi: 10.5435/JAAOS-D-16-00928. PMID: 32574474