Our Summary

This research paper discusses hip arthroscopy, a medical procedure used to diagnose and treat problems in the hip joint. The procedure is becoming more popular due to its positive results in treating conditions like femoroacetabular impingement syndrome and labral tears. However, it’s also considered one of the most challenging procedures in the field of orthopedics.

The biggest challenge is safely gaining access to the hip joint, which requires detailed knowledge of the body’s anatomy, a good sense of spatial awareness, and plenty of practice. The most common complication is damage to the cartilage and labrum (a type of soft tissue) of the hip, which often happens when trying to access the hip joint.

The researchers stress the importance of basic foundational knowledge and skills to reduce these complications. They suggest that proper patient positioning, reliable techniques to access the hip joint, and correct placement of surgical instruments are crucial.

The paper presents a step-by-step approach for safely accessing the hip joint during arthroscopy, aiming to help orthopedic surgeons overcome the major challenges of this procedure.

FAQs

  1. What is hip arthroscopy and what conditions is it typically used to treat?
  2. What are the main challenges faced by orthopaedic surgeons when performing hip arthroscopy?
  3. How can the common complication of iatrogenic chondrolabral injury be minimized during hip arthroscopy?

Doctor’s Tip

One helpful tip a doctor might tell a patient about arthroscopy is to follow post-operative care instructions carefully to ensure proper healing and minimize the risk of complications. This may include keeping the surgical site clean and dry, taking prescribed medications as directed, attending follow-up appointments, and participating in physical therapy as recommended. Additionally, it is important to communicate any unusual symptoms or concerns to your doctor promptly.

Suitable For

Patients who are typically recommended for arthroscopy are those with pathologic conditions such as femoroacetabular impingement syndrome and labral tears. These patients may experience symptoms such as hip pain, stiffness, and limited range of motion. Arthroscopy is often recommended when conservative treatments such as physical therapy and medication have not provided relief. It is important that patients are properly evaluated by a healthcare provider to determine if arthroscopy is the best course of treatment for their specific condition.

Timeline

Before arthroscopy:

  1. Patient presents with hip pain and limited range of motion.
  2. Patient undergoes physical examination, imaging studies (such as X-rays and MRI), and possibly other diagnostic tests.
  3. Orthopedic surgeon recommends hip arthroscopy as a treatment option.
  4. Patient undergoes pre-operative evaluations, including medical history, physical examination, and possibly blood tests.
  5. Patient receives instructions on pre-operative care, such as fasting before surgery and stopping certain medications.

After arthroscopy:

  1. Patient undergoes hip arthroscopy procedure, which typically lasts 1-2 hours.
  2. Patient is monitored in the recovery room immediately after surgery.
  3. Patient is discharged home on the same day or may stay overnight in the hospital.
  4. Patient is given post-operative care instructions, including pain management, wound care, and physical therapy exercises.
  5. Patient attends follow-up appointments with the orthopedic surgeon to monitor healing and progress.
  6. Patient gradually resumes normal activities and physical therapy to strengthen the hip joint and improve range of motion.
  7. Patient experiences reduced pain and improved function in the hip joint over time as they recover from arthroscopy.

What to Ask Your Doctor

  1. What specific condition or issue are you planning to address with the arthroscopy procedure?
  2. What are the potential risks or complications associated with hip arthroscopy?
  3. How experienced are you in performing hip arthroscopy procedures?
  4. What is the expected recovery time and rehabilitation process after the procedure?
  5. Are there any alternative treatment options available for my condition?
  6. How long will the effects of the arthroscopy procedure last?
  7. What type of anesthesia will be used during the procedure?
  8. Will I need to follow any specific pre-operative instructions before the procedure?
  9. What can I expect in terms of pain management during and after the procedure?
  10. How soon after the arthroscopy procedure can I resume normal activities or sports?

Reference

Authors: Maldonado DR, Rosinsky PJ, Shapira J, Domb BG. Journal: J Am Acad Orthop Surg. 2020 Aug 15;28(16):651-659. doi: 10.5435/JAAOS-D-19-00856. PMID: 32769716