Arthroscopy is a minimally-invasive surgical technique commonly performed on many joints including the shoulder, knee, elbow, hip, ankle and wrist by making small incisions around the joint to allow for insertion of a small camera. Once inside the joint, other small incisions, called portals, can be made to allow insertion of tools used to perform a variety of surgeries. Hip arthroscopy is performed by distracting the hip joint, separating the ball from the socket to allow for insertion of the camera and tools. Using 2-3 common portals in the front aspect of the hip, a variety of common hip injuries, including hip impingement, labral tears, cartilage injuries, loose bodies, snapping hip and hip instability, can be effectively treated.
Using this minimally-invasive technique allows for less swelling, less soft tissue dissection and muscle disruption, excellent visualization and effective treatment of most hip injuries. Hip arthroscopy generally takes 1-2 hours on average depending on the extent of the hip injury and bony deformity. Hip arthroscopy does have technical limitations. When these limitations are present, other open surgeries are needed including pelvic and femoral osteotomies and surgical dislocation of the hip. The following can all be performed using arthroscopic techniques: labral repair, labral reconstruction, cam resection, pincer resection, capsule closure/tightening, and hip flexor lengthening.
Recovery after hip arthroscopy varies depending upon the injury severity and type, surgical procedures performed, efficacy of therapy, required activity and functional demands. Hip arthroscopy does not require a hospital stay and is performed the same day, allowing patients to go home for recovery. You will be provided several medications post-operatively. These medications will be outlined in a packet that will be provided to you prior to surgery by Dr. Ryan’s staff. In addition to pain medications, a cold-compression device will be highly recommended, as this greatly helps decrease post-operative pain and swelling and reduces the need for narcotic pain medication. Unfortunately, this is not covered by insurance, but we will do our best to assist you in obtaining this device after surgery. Your rehabilitation will commence the following business day, and an outpatient physical therapy prescription and protocol will be provided. A recommendation to a physical therapy clinic, experienced in post-surgical hip treatment, that is convenient for you will also be provided. Proper and diligent therapy is crucial for achieving a good result after surgery. In general, patients require a period of protected weight-bearing for 2-6 weeks to protect any surgical repairs. Additionally, a brace will be provided and required at all times (except PT and personal hygiene) for 4-8 weeks to protect you from putting your hip in positions that may cause damage to the repair. A minimum of three post-op visits will be scheduled for you after surgery (typically around 2, 6 and 12 weeks after surgery). Provided your motion, function and pain are improved, a running program may begin 3 months after surgery, followed by specific return-to-sport protocols for athletes seeking to return to play. On average, most athletes need 6 months to feel ready to return to play at or near the same level prior to surgery, though some may take longer. Ultimately, your ability to return to work, fitness, running and athletics will be determined with your surgeon, therapist and trainer.