Hip Arthroscopy

 Hip arthroscopy is a minimally invasive surgical procedure  performed through small incisions (about one to two  centimeters each) using a tiny camera to visualize the  inside of the joint. Frequently an outpatient procedure, hip  arthroscopy patients recover and resume normal activities more  quickly than patients with traditional hip surgery.

Hip arthroscopy has been used to treat elite athletes and  professional dancers with hip injuries, but is now available for  patients with several conditions. The number of surgical centers that  offer the procedure is, however, still limited, and in Southern  California, Eisenhower Medical Center is one of only a handful of  centers where hip arthroscopy is an option.

Matthew V.Diltz,MD, is an Orthopedic Surgeon at Eisenhower  Medical Center who specializes in sports medicine. Formerly a  physician to the Boston Ballet and Northeastern University,Dr.Diltz  says the new procedure is most frequently used to treat conditions  that require an evaluation and possible repair or removal of damaged  tissue in the joint. These can include labral tears (a tear in the  labrum, the thick tissue that surrounds the hip socket), and cartilage  damage. It is also used to prevent the progression of early arthritis,  and specifically, impingement or pinching within the hip joint.

We typically treat patients who have the beginnings of arthritis  with hip arthroscopy,” says Dr.Diltz.“They are not candidates for a  full hip replacement, but they are starting to have impingement,  which is an abnormal friction between the ball and socket of the hip  joint that causes damage to the outer labrum and eventually the  cartilage.”Dr.Diltz uses a small incision to go in with a camera,  determine where the bones are hitting one another and make repairs.

“Before hip arthroscopy, the only way to treat that impingement  was through surgery that required a large incision, and then a  breaking of the bone in order to dislocate the hip and chisel away  pieces of the bone,” says Dr.Diltz.“We’d then put the hip back into  place using screws. It was a major procedure with a long recovery  period.Now, we can accomplish the same goal using an outpatient  procedure, with much quicker recoveries.”

Dr. Diltz believes that treating impingement with hip arthroscopy  can help preserve the hip joint.“One of the reasons people have early  arthritis of the hip is the impingement,” explains Dr.Diltz.“If we can  keep those bones from knocking together, we can hopefully preserve  the hip joint longer, and perhaps prevent hip replacements later in  the life. That’s the goal.”

Dr. Diltz typically keeps patients overnight following hip  arthroscopy to begin movement of the joint.After 24 hours,most  patients do not experience serious pain.Depending on the reason for  surgery, recovery includes two to three weeks on crutches to keep  pressure off of the surgical area.Most patients can begin light, nonweight-  bearing activities (cycling, swimming) within a few weeks.  Athletes can typically return to their sports within 12 weeks; others  may require more recovery time.

“It’s important to catch impingement early, so if someone is having  hip pain, or feels a click, or a catch, they should have it looked at so  the joint does not begin to wear out more quickly than it should,”  cautions Dr.Diltz.“If arthritis progresses too much, and an  individual has lost a lot of cartilage, it’s difficult to treat it with  hip arthroscopy.”