Lifewatch: Arthroscopic hip surgery

Reported by Claire Hosmann - email
Posted by Debra Worley - email

(WECT) - People with chronic hip pain can't even get into a car without wincing.

A new approach to surgery repairs the hip instead of replacing it.

In the past, people who suffered from hip pain didn't have many options other than surgery, but now their is another way to fix hip problems.

A new technique has been proven to relieve pain and improve joint stability.

34-year-old Sarah Harris learned hip problems can hit at any age.

"The pain was a shooting pain down the front of my thigh. It almost as though something was digging down into my thigh," said Sarah.

The pain came from a condition called impingement syndrome.  The cartilage at her hip joint was torn.

Every time Sarah moved, the cartilage would get pinched in the hip socket.

In the past patients had to suffer until a hip replacement was required. Thankfully for Sarah, times are changing.

Dr. Mark Lawler is one of a few surgeons repairing hips with an arthroscopic procedure.  He makes two small incisions, inserts a scope and other tools and sews the cartilage back in place.

"Then we go down and there's some boney impingement of which we actually remove some boney spurs off the cup and the neck of the femur, hopefully resolving the problem," said Lawler.

Compared to a hip replacement, the arthroscopic approach requires no hospital stay, patients don't need blood thinners, and recovery time is nearly cut in half.

"It's a same-day surgery. People come and go," said Lawler.

five weeks after surgery, Sarah is learning what it's like to live pain free.

Having the procedure earlier in life may prevent people from having problems in the future.  It also has fewer risks than open surgery or a hip replacement.

For more information, please contact:
Marin Orthopedics & Sports Medicine
San Rafael, CA
(415) 492-1600

The hip is the largest weight-bearing joint in the body and is made up of a ball and socket. When the hip is healthy, the head of the femur (the ball) fits into a cavity at the base of the pelvis called the acetabulum (the socket).

Hip impingement is caused by a lack of room, or clearance, between the head of the femur and the rim of the acetabulum. Because of this lack of room, when the hip is flexed during activities like running, sitting or bending over, the femur and the rim of the acetabulum rub together.

The repetitive rubbing can cause significant pain in the joint. Hip impingement can also cause a tear in the fibrous cartilage that lines the rim of the acetabulum, called the labrum.

Hip impingement is most common in athletic men. Any strenuous activity may aggravate the pain. Remaining stationary in a seated position for a long period of time may also aggravate the condition. If conservative treatments don't work to relieve the pain associated with impingement, surgery may be the best option.

TREATMENT: Conservative treatment options for treating hip impingement that do not require surgery include physical therapy, anti-inflammatory medications and corticosteroid treatment. If none of these treatment options are successful, a surgical procedure may be recommended.

In the past, patients who suffered from hip impingement usually had to wait until the joint had deteriorated enough to require a full hip replacement.

Now, doctors are using an arthroscopic procedure to repair hip problems associated with impingement in a minimally invasive way. Arthroscopic hip surgery can relieve pain, improve joint stability, remove loose bodies, repair tears and damage, delay the onset of osteoarthritis, delay the need for total hip replacement, improve the patient's quality of life and optimize daily activities.

During an arthroscopic surgery to treat hip impingement, a surgeon reshapes the junction between the head and neck of the femur using small mechanical resection devices called burrs. Doing this, along with trimming any excessive portions of the acetabulum, will give the joint more clearance, thus relieving the impingement.

To treat a labral tear, a surgeon smoothes the edges of the torn or frayed labrum using shaver blades or radio frequency (RF) energy. Specially designed RF probes with flexible heads allow a surgeon to maneuver through the curves of the hip joint to remove torn tissue or smooth rough edges.

In some cases the labrum can be repaired, which involves putting sutures in the tissue and anchoring them to the bone. Arthroscopic hip procedures are done on an outpatient basis and require no hospital stay.

Compared to hip replacements, arthroscopic hip surgeries require about half the recovery time and cost about half as much.