Hip Arthroscopy
What is Hip Arthroscopy?
Hip arthroscopy is a surgical procedure that allows doctors to view the hip joint without making a large incision (cut) through the skin and other soft tissues. Arthroscopy is used to diagnose and treat a wide range of hip problems.
During hip arthroscopy, your surgeon inserts a small camera, called an arthroscope, into your hip joint. The camera displays pictures on a video monitor, and your surgeon uses these images to guide miniature surgical instruments.
Because the arthroscope and surgical instruments are thin, your surgeon can use very small incisions, rather than the larger incision needed for open surgery. This results in less pain for patients, less joint stiffness, and often shortens the time it takes to recover and return to favorite activities.
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General information about Hip arthroscopy
The following table describes general information about Hip arthroscopy surgery including Hip arthroscopy cost in Iran, recovery time, and to name but a few.
| General Information | |
| Cost | Starts from $ 600 |
| Anesthesia | General |
| Hospital Stay | The same day |
| Back to Work | 1-2 Weeks |
| Duration of Operation | 30 to 90 Minutes |
| Minimum Stay in Iran | 1 Week |
About Iranian Surgery
Iranian surgery is an online medical tourism platform where you can find the best orthopedic Surgeons and hospitals in Iran. The price of a Hip arthroscopy procedure in Iran can vary according to each individual’s case and will be determined based on photos and an in-person assessment with the doctor. So if you are looking for the cost of Hip arthroscopy procedure in Iran, you can contact us and get free consultation from Iranian surgery.
Before Hip Arthroscopy
Anatomy
The hip is a ball-and-socket joint. The socket is formed by the acetabulum, which is part of the large pelvis bone. The ball is the femoral head, which is the upper end of the femur (thighbone).
A slippery tissue called articular cartilage covers the surface of the ball and the socket. It creates a smooth, frictionless surface that helps the bones glide easily across each other.
The acetabulum is ringed by strong fibrocartilage called the labrum. The labrum forms a gasket around the socket.
The joint is surrounded by bands of tissue called ligaments. They form a capsule that holds the joint together. The undersurface of the capsule is lined by a thin membrane called the synovium. It produces synovial fluid that lubricates the hip joint.
What conditions are treated by hip arthroscopy?
A hip arthroscopy may be recommended if your hip pain hasn’t responded to non-surgical treatments such as rest, physiotherapy, medications and injections.
Hip arthroscopy can be used to surgically treat femoroacetabular impingement (FAI), or hip impingement syndrome. Arthroscopy is used to treat:
. Abnormalities of the femoral head: The head of the femur is reshaped and made smooth, allowing it to rotate through its full range of motion.
. Abnormalities of the acetabulum: The hip socket is reshaped, allowing the femoral head to fit more securely and rotate through its full range of motion.
. Labral tears: Torn labrum is reattached, repaired, and stabilized.
. Ligamentum Teres Tears: The ligamentum teres can be trimmed and stabilized.
. Bone cysts: Holes in the femoral head or acetabulum are removed or filled with a bone graft.
In addition to FAI, other conditions that can be treated by hip arthroscopy include:
. Cartilage damage
. Loose bodies
. Labral tears
. Iliopsoas tendinitis
. Trochanteric bursitis
. Synovial disease
. Adhesive capsulitis
. Joint sepsis
. Osteonecrosis
Hip arthroscopy can be performed if there are no apparent signs of arthritis. If moderate to severe arthritis is present, the surgeon may recommend a partial or total hip replacement instead.
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Advantages
What are the advantages of hip arthroscopy?
. Less Tissue Damage
Arthroscopic surgery preserves muscles in three ways. First, the surgeon only makes a small number of incisions that are each approximately 1 cm long. Second, the incisions are made on the front side of the hip where there is naturally less muscle. Finally, the procedure is performed with highly specialized instruments that allow the surgeon to work between tissue. The surgeon does not need to cut or remove tissue in order to access the joint.
These aspects of arthroscopic surgery are vastly different from traditional hip surgery. A traditional procedure involves a large incision that is approximately 10-12 inches long. Moreover, muscles and tendons are detached from bones and the femoral head is dislocated from the hip socket in order to have a complete view of the joint.
. Less Postoperative Pain
Patients of arthroscopic surgery usually experience less pain because there is less tissue that needs to heal. These patients also require less pain medication.
. Faster Recovery
Recovery time depends on the type of hip arthroscopy performed. If the purpose of surgery is to remove torn pieces of cartilage or foreign bodies from the hip, the patient may be able to place their full weight on the joint after two or three days. Alternatively, if the purpose of surgery is to repair the anatomical structures of the joint, the patient will often be able to resume activities within 3 to 4 weeks. Those who work less physically demanding jobs often return to work sooner. Patients of traditional surgery may need up to 8 weeks in order to return to activities.
. Shorter Hospital Stay
Hip Arthroscopy surgery is usually conducted on an outpatient basis, where the patient returns home on the same day as the surgery.
. May postpone the advancement of hip arthritis by treating its cause in the early stages.
. Can delay or eliminate the need for a hip replacement by preemptively treating conditions that cause osteoarthritis of the hip.
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Risks and Complications
What are the Risks of Hip Arthroscopy?
The risk of complications from hip arthroscopy is low and many of its potential complications are transient. However, it’s important for patients to understand the following conditions that can result from surgery:
. Bleeding
. Infection in the hip joint
. Blood vessel and nerve damage
. Blood clots and pulmonary embolism
. Fluid build-up in the body
. Extra bone around the hip
. Scarring
. Difficulty passing urine
. Tendon damage
. Localized stiffness or pain
. Numbness
. Swelling
In general, the risk of a complication increases with age and a history of smoking. Although rare, serious complications can occur such as the loss of limb function or anesthesia complications that can lead to death. Your physician will provide a comprehensive evaluation of your health in order to determine your level of risk.
Who is a Candidate for Hip Arthroscopy?
Candidates for arthroscopic hip surgery suffer from severe pain or experience decreased mobility that limits their ability to live a normal life. Candidates typically have FAI, a labral tear (which may or may not be related to FAI), hip dysplasia, loose bodies in the hip area, or another condition that leads to hip pain and loss of function.
Candidates for hip arthroscopy range in age from late teens to people in their 50’s and 60’s. Patients who are young and healthy, in particular, tend to be good candidates because they have less tissue surrounding the joint. Because the hip joint is located deep within the body, minimal tissue makes it easier for the surgeon to operate.
Hip arthroscopy is not appropriate for patients with moderate or severe arthritis. Instead, the best surgical treatment is a partial or total hip replacement.
It is important to note that surgery is not appropriate for every patient. It is also considered a method of last resort. Your physician will first recommend conservative treatments, including physical therapy, to help you manage your hip pain, swelling, and stiffness. If you are not able to achieve significant pain relief and mobility, your physician may conduct a comprehensive orthopaedic evaluation to determine if surgery is the appropriate treatment for you.
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During Hip Arthroscopy
During Procedure
Arthroscopic hip surgery is usually conducted on an outpatient basis, where the patient returns home on the same day as the surgery. Depending on your doctor’s findings and the type of treatment that will be performed, arthroscopic hip surgery may take between 30 minutes and 90 minutes.
Hip arthroscopy is performed under a general anaesthetic (you are asleep) using small cuts through which a camera (to see the joint) and instruments are passed.
You will be positioned with your leg pulled in traction. This creates space in the hip joint and allows instruments to access the joint without injuring surrounding cartilage. Accessing the narrow space in the hip joint is complicated by the orientation of surrounding nerves and blood vessels. To ensure the arthroscope and instruments are inserted properly, a portable X-ray device called a fluoroscope will be positioned for use during the procedure.
Your surgeon will make two or three small, one-quarter to one-half inch long incisions called portals along pre-marked sites.
First, a needle will be inserted into the joint space, and when positioning is confirmed with the fluoroscope, the joint is injected with a sterile, water-based solution, creating fluid pressure to help hold open the joint. An incision is made, and a guide wire is passed through the needle, which is withdrawn.
Next, a thin tube, called a cannula, is inserted over the guide wire into the joint space. The wire is withdrawn, and an arthroscope is inserted through the cannula to visualize the joint. The other one or two portals are accessed similarly, and once complete, the location of the arthroscope or instruments can be changed to view the joint or repair tissues from a variety of positions. Fluid may be directed into and out of the joint through attachments on the arthroscope or via other portals to aid viewing inside the joint.
Once exploration and any treatments are complete, your surgeon will withdraw the arthroscope and any other instruments. Your incisions may be closed with two to three non-dissolvable sutures and covered with small bandages, or they may be held closed with wound closure surgical tape strips.
You may be given a prescription for pain and directed to ice the area. Your doctor may also advise you on what to wear after hip arthroscopy, such as a brace and types of clothing to accommodate a brace. You may also need to walk on crutches or otherwise limit weightbearing on your leg for a period of time.
After Hip Arthroscopy
Recovery
After surgery, you will stay in the recovery room for 1 to 2 hours before being discharged home. You will need someone to drive you home and stay with you at least the first night. You can also expect to be on crutches, or a walker, for some period of time.
. Medications
In addition to medicines for pain relief, your doctor may also recommend medication such as aspirin to lessen the risk of blood clots.
. Bearing Weight
Crutches may be necessary after your procedure. In some cases, they are needed only until any limping has stopped. If you required a more extensive procedure, however, you may need crutches for 1 to 2 months. If you have any questions about bearing weight, call your surgeon.
Your surgeon will develop a rehabilitation plan based on the surgical procedures you required. In most cases, physical therapy is necessary to achieve the best recovery. Specific exercises to restore your strength and mobility are important. Your therapist can also guide you with additional do’s and dont’s during your rehabilitation.
. Pain – You may feel some pain in your hip as well as other areas such as your lower back, buttock or knee. It is important you take your prescribed pain relief in order to help with this pain. You may also notice some swelling around the hip and groin. This is normal and should go down over the first few days.
You may find that after the operation you have some pain at the front of your hip, near where the scars are. This area and the area around your hip bone may also feel tender to the touch. This can be due to inflammation of one of the tendons around the hip. Unless there are any contra-indications (reasons why two drugs or procedures should not be used together) we would recommend regular anti-inflammatory tablet usage for the first two weeks after surgery to help with this. Using an ice pack over the area may also help. Your physiotherapist should also be able to recommend some stretches for this area.
. Walking –You will be seen by a physiotherapist following your surgery and they will teach you some initial exercises as well as help you to learn to walk with the use of crutches. How much weight you are allowed to put through your operated leg depends on the surgeon’s instruction. If your weight bearing is restricted, this can be for up to for 6 weeks but depends on the procedure the surgeon has performed. If you have stairs at home your physiotherapist will show you how to manage these safely.
. Wound care – It is normal for the wound sites to sometimes leak a little bit of blood or fluid in the first few days after your surgery. The nursing staff will discuss taking care of your wound with you. You will need to see a nurse at your doctor’s surgery to have the stitches taken out at about 10-12 days after your surgery.
. Driving – You can drive once you are fully weight bearing and it is comfortable to do so. You must be able to perform an emergency stop without hesitation. It is also a good idea to check the terms of your motor insurance policy with your insurance company to ensure it is valid, as some policies state you must not drive for a certain period of time following an operation.
. Work –You may return to work when the pain has settled and you are confident that you can manage. If your job is not physically demanding, this can be after 1-2 weeks.
However, if you have a physically demanding job this can be longer, taking up to 8-12 weeks. An initial sick certificate can be provided by the ward – please ask the nurse before you leave the ward. Subsequent certificates will need to be obtained from your GP.
. Sports – Return to sports will depend on what you have had done during your hip arthroscopy. You will need to stop doing sports until you are fully weight bearing. Even at this point you should avoid any impact sports or swimming breast stroke. It can take up to 3-6 months before you are able to return to competitive sports. It is important you follow the advice from your surgeon and physiotherapist.
. Cycling – It is fine to start using an exercise bike already after about one week. We generally recommend low resistance and not more than about 50-60 rpm. Building up time on the bike according to how the hip feels is very good.
. Rehabilitation – This usually begins within 1-2 weeks of your hip arthroscopy. A physiotherapist will assess you and provide you with some exercises. Depending on the assessment findings your physiotherapist may refer you for hydrotherapy (pool) treatment.
However, not every patient requires this. It is very important that you do the prescribed exercises as they will help to build the strength in and around your hip. Your physiotherapist will then continue to review you and progress your exercises as necessary.
. Follow up appointment – You will have an appointment to see the consultant or a member of their team at 6 weeks after your operation.
Long-Term Outcomes
Many people return to full, unrestricted activities after arthroscopy. Your recovery will depend on the type of damage that was present in your hip.
For some people, lifestyle changes are necessary to protect the joint. An example might be changing from high impact exercise (such as running) to lower impact activities (such as swimming or cycling). These are decisions you will make with the guidance of your surgeon.
Sometimes, the damage can be severe enough that it cannot be completely reversed and the procedure may not be successful.