Conditions Treated

Hip arthroscopy involves several small incisions around the hip that allow a small camera and instruments access to the hip joint. This minimally invasive procedure allows for outpatient surgery, very little scarring, faster recovery, prompt rehabilitation, and a quicker return to activities. This animation from the Hospital for Special Surgery is a great overview of hip arthroscopy.

Before hip arthroscopy, a traditional open procedure was utilized which required a large incision and dislocation of the hip. This had the potential of causing more soft tissue damage as well as increased complications, bleeding and pain.

Labral Tears

Large labrum tear in the hip, as seen on hip arthroscopy.

The labrum of the hip is a cuff of thick tissue that surrounds the hip socket. It works in a very similar way to a rubber washer or gasket. The labrum helps keep fluid inside the joint and also stabilizes the hip joint. When a labral tear of the hip occurs a piece of this tissue can become pinched in the joint, causing pain and catching sensations.

A labrum repaired with hip arthroscopy.

Hip arthroscopy can help labral tears by either repairing the labrum using small anchors and stitches, or by debriding the torn piece. Dr. Wagner prefers to repair the labrum since that helps restore the hip's normal anatomy and labral function.

Femoroacetabular Impingement (FAI)

Bone overgrowth being burred down on a patient with severe Femoroacetabular Impingement.

The side of the femoral head impinging on the acetabulum (hip socket) causes Femoroacetabular Impingement (FAI). Impinging can be caused from an overgrowth of bone – either on the femoral head, the acetabulum, or a combination of both. This impinging can often cause labral tears, cartilage tears, or early arthritis.

No more femoral neck impingement on the repaired labrum after osteoplasty of the femoral neck.

Hip arthroscopy is used to trim the overgrowth of bone so the impinging no longer occurs. Any concurrent injuries to the labrum or cartilage can be addressed at the same time.

Loose Bodies

Sometimes loose bodies – typically from cartilage or bone – can cause instability of the hip joint. This can lead to a sudden, sharp pain in the hip, sometimes causing a fall.

These loose bodies can be removed arthroscopically, which allows the patient to resume full activities, sometimes within days after the surgery.

Iliopsoas Tendonitis

The iliopsoas tendon is one of the main flexors of the hip. Irritation of this tendon, called Iliopsoas tendonitis, can be a common source of hip or groin pain caused from an injury, overuse, or irritation from a total hip replacement.

This hip pain can be extremely disabling, but can be relieved with a small, endoscopic surgery if conservative measures fail.

Synovitis

Synovitis is an irritation or inflammation of the lining inside the hip joint, commonly seen with other problems inside the joint. Synovitis is treated with debridement using specialized shavers.

Cartilage Tears

A young woman who had cartilage tears and delamination.

Typically seen with Femoroacetabular Impingement, cartilage tears can cause instability of the hip and pain – and can continue to get bigger without treatment.

Hip arthroscopy can trim out the unstable cartilage, or in some cases perform a microfracture of the bone to stimulate the growth of new cartilage.