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Hip Arthroscopic Surgery: Before, During and After FAQ From Tristan A. Altbuch, M.D.

Surgical repair may be required when a hip injury or condition is severe enough and conservative treatments fail to produce successful outcomes. Hip surgery once involved a large, open incision and significant recovery time. Today, many hip problems can be surgically corrected with hip surgery that is performed through small incisions and camera-guidance in a technique called arthroscopy.

Arthroscopy hip surgery (minimally invasive hip surgery) offers a number of advantages over traditional hip surgery, possibly including lower risk of complications, shorter recovery period, and less scarring.

As a board-certified, fellowship trained orthopedic surgeon in sports medicine, Dr. Altbuch regularly answers questions about hip problems and more specifically, hip arthroscopy. In this article, he addresses the most frequently asked questions about hip arthroscopy surgery.

Q: What is hip arthroscopy?

Hip arthroscopy is a relatively new, minimally invasive procedure used to diagnose and treat a variety of hip conditions, such as hip pain while bending or twisting. It is an excellent alternative to treatments that previously would have required more invasive, open surgical procedures. Arthroscopic hip surgery, also called hip arthroscopy or minimally invasive hip surgery, uses a video camera inserted through small incisions to visualize the inside of the hip joint. With this camera-guidance, a doctor can view the joint up close and make necessary repairs with great precision. Surgery will be performed on an outpatient basis to reduce patient downtime and expedite recovery.

A physician will obtain a full medical history to rule out any other abnormalities that may contribute to hip pain. In many cases, physical therapy and over-the-counter medications like Advil or Motrin may be recommended. Stretching exercises may also help to alleviate pain surrounding the hip area.

“I prefer this technique because it is less invasive than conventional surgery. With hip arthroscopy, patients may have the ability to resume their normal routine with less downtime,” Dr. Altbuch explains.

Q: What type of hip injuries would arthroscopic hip surgery be used for?

Non-operative management and traditional surgery may still be the preferred methods of treatment for many hip problems. When surgery is necessary, you should consult with an experienced orthopedic surgeon who can explain your options and determine whether a minimally invasive hip procedure would be best for your needs.

Hip arthroscopy is a less-invasive treatment which can be performed to definitively diagnose or repair the following:

Labral tears
Cartilage tears
Loose pieces of bone or cartilage
Other hip injuries

The hip joint is composed of the head of your upper leg bone, the bony socket of your hip, and a great deal of soft tissue including cartilage and tendons. Injuries to the soft tissues, as well as numerous other types of hip injuries may be good candidates for hip arthroscopy.

Q: What are the advantages of hip arthroscopic surgery?

Hip arthroscopy offers a number of advantages over traditional hip surgery, possibly including:

Less downtime
Faster recovery
Typically performed on an outpatient basis
Less scarring
Reduced risk of complications during and after surgery

“We’re seeing more and more data that patients recover quicker, discontinue use of a cane or walker sooner, and have a quicker return to a normal gait,” explains Dr. Altbuch

Q: Who are candidates for hip arthroscopy

For many conditions affecting the hip, arthroscopy is considered an ideal treatment since it offers shorter recovery times, smaller incisions and less scarring. “Patients can often return home the same day and go back to resuming their regular activities in several weeks,” explains Dr. Altbuch.

Arthroscopy offers the possibility of less pain, less risk of infection, restored joint function and greater range of motion. It is ideal for most ages and offers a less invasive option than conventional hip surgery.

Q: What is the hip arthroscopic procedure?

The procedure begins by the surgeon making a small incision near the affected area of the hip. An arthroscope, which is a long tube with a camera and a light on the end, is inserted and displays real-time magnified images of the inside of the hip joint on a video monitor.

With arthroscopy, “The surgeon is then able to quickly diagnose any tears, damage or degeneration to cartilage, ligaments or other internal structures,” says Dr. Altbuch.

Once damage is detected, it can often be repaired during the same procedure by creating small incisions through which surgical instruments are inserted. The surgeon can remove loose bodies, repair damaged cartilage and remove excess bone to reduce pain and inflammation. When a repair is made, the arthroscopic device and surgical tools are removed and the incisions are sutured closed. A dressing is applied, but as the incisions heal, they will be replaced with smaller bandages.

Q: What is recovery like?

After the procedure, patients may experience pain, swelling and bruising at the incision sites for several days. To reduce inflammation and manage pain, pain medication may be prescribed while icing the area is advised.

Recovery varies with each person. It is essential that you follow your orthopaedic surgeon’s instructions regarding home care during the first few weeks after surgery; especially concerning the exercise program you are prescribed. You should be able to resume most normal light activities of daily living within three to six weeks following surgery. Some discomfort during activity and at night is common for several weeks. Complete recovery can take from about three to six months.

Most patients will be encouraged to get up and walk as soon as possible but will need crutches or a walker for 7 to 10 days while healing. Dr. Altbuch emphasizes the rapid recovery time associated with hip arthroscopy, “Total recovery takes six months but patients usually return to routine light physical activity after several weeks.”

Patients will undergo a customized physical rehabilitation program after surgery to meet their individual goals. Physical rehabilitation may include weight-bearing exercises, flexibility exercises and other activities that target the various muscles of the region including the gluteals, quadriceps and hamstrings.

What are the risks of hip arthroscopy?

While hip arthroscopy is considered safer and more efficient than conventional hip procedures, there are still certain risks associated with any type of surgery. Patients should discuss these and other risks with the doctor before undergoing hip arthroscopy.

Some of these risks may include:
Tissue damage
Nerve or blood vessel damage
Prolonged pain
Blood clots
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Dr. Altbuch is a board-certified, fellowship trained orthopedic surgeon who specializes in arthroscopic surgery, joint replacement surgery, orthopedic surgery and sports medicine. His most common procedures are shoulder surgery for rotator cuff repair and shoulder, hip and knee replacements. He also regularly performs knee surgery for ACL reconstruction as well as meniscus and cartilage repair. What sets him apart is his compassion, attention to detail and meticulousness. He also treats a broad spectrum of musculoskeletal problems and patients of all ages. Outside of orthopedics, Dr. Altbuch enjoys spending time with his family, fishing, golfing and exercise.

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