Orthopedic

Treatments

Hip arthroscopy and hip replacement treat different conditions and different types of patients.

Most patients who get hip arthroscopy: 

• Are active and younger than 60 with certain hip conditions and little arthritis
• Are diagnosed with one of these conditions:
  • Fragments of bone or cartilage floating inside the joint
  • Hip (femoroacetabular) impingement - Your femur bone rubs against the rim of the hip socket. This causes pain and often causes a labral tear. Hip impingement can lead to osteoarthritis.
  • Labral tear- The labrum serves as the "O-ring" or gasket of the hip joint. It deepens the socket and keeps the joint lubricated for smooth movements.
• Feel pain and have limited hip function
• Some patients can be older than 60

Candidates for hip replacement are usually:

• Diagnosed with osteoarthritis in the hip
• Older than 60
• Require a totally new joint to restore movement and stop pain

Hip arthroscopy repairs are intended to be permanent or last for many years. The procedure may delay the need for hip replacement in many patients.

The most common symptom for patients who qualify for hip arthroscopy is groin pain. Sometimes the pain is felt on the outside of the hip or in the buttock region. The pain is usually caused by a labral tear or hip impingement.

You may be a good candidate for hip arthroscopy if:

• Your ability to take part in regular activities becomes limited over time
• You get no relief from anti-inflammatory medicines, cortisone injections or physical therapy
• Your pain persists for three to six months

Patients who benefit from hip arthroscopy include athletes and non-athletes, teens and men and women older than 30. There is no one common patient profile. Athletes may be more at risk for these hip conditions, but anyone with significant and limiting hip pain may benefit from getting it fixed.

Your surgeon performs hip arthroscopy as an outpatient procedure, that you go home the same day as your surgery.

You go to sleep under general anesthesia. Your doctor makes small incisions in your hip and inserts flexible instruments about the size of a drinking straw equipped with a light and a camera. Your doctor uses specialized tools to remove or reshape bone and repair or reconstruct the labrum cartilage. On the day of surgery:

• You arrive two hours before your scheduled surgery
• You meet with your anesthesiology team
• Your anesthesiology team takes you to the operating room and puts you to sleep under general anesthesia.
• Your doctor places your leg under traction. This pulls the ball and socket away and makes it easier to access the labrum.
• If needed, your surgeon uses an arthroscopic burr to reshape bone on the femur or socket.
• Your doctor places small, non-metallic anchors placed into the rim of the socket.
• The anchors contain sutures that are used to thread through and repair a torn labrum.
• Once the labrum is fixed, your surgery team takes your leg out of traction.
• Your surgeon moves your leg in different directions to ensure there is full range of smooth motion without impingement.
• The surgery team takes a series of X-rays to ensure that the right amount of bone was removed and that the bones are properly aligned in the joint.
• If everything looks good, your surgeon closes the hip capsule (a group of three ligaments), to ensure joint stability.
• Your doctor removes all surgical tools, injects numbing medication to help control pain and uses sutures to close the skin.

Our hip arthroscopy team provides the most advanced care to give you the best results, whether you come to us for your first surgery or need repairs to a previous hip arthroscopy. We lead research studies to test innovative techniques and improve outcomes. We put what we learn into practice right away.

Our approach includes

• Capsular management
• Reconstruction, rather than removal, for a more stable, stronger joint; such as:
  • Capsular reconstruction
  • Labrum reconstruction
• Revision surgery

Dr. Bryan Whitfield leads the hip arthroscopy team at Emory Healthcare. He is a fellowship-trained Sports Medicine Orthopaedic Surgeon. He works with high-level athletes, any and all active individuals and patients who do not consider themselves athletes to improve their quality of life while using advanced, minimally invasive joint preservation techniques.

Our minimally invasive approach to hip arthroscopy means you experience less pain and damage to your joint. Here’s what you can expect in the first two weeks after surgery:

• Patients are generally instructed to put minimal weight on their joint and walk with crutches or a walker in the first three to six weeks depending on the exact operation.
• Your surgeon gives you exercises to do for gentle hip motion.
• At two weeks, your doctor removes your stitches.
• After two weeks, you notice reduced pain and inflammation. Formal physical therapy typically begins at this point.

Your recovery process will be slow and steady. For most patients:

• You start physical therapy two weeks after surgery. You continue physical therapy for four months or more.
• You transition to normal walking between three to six weeks.
• Your pain improves and feels less intense than before you had surgery, typically by six to 12 weeks, sometimes sooner.
• After four or six months, you are finally ready to return to all activity including sporting activities without restrictions.

Hip arthroscopy restores your hip joint to the appropriate shape and stability to decrease pain and increase function. We expect the repair and improvements in your hip to last a long time and provide the pain relief you need.

At Emory Healthcare, your hip arthroscopy team specializes in this surgery.  We perform this specialized surgery weekly to bring you the experience and expertise you expect from Emory.  We work continuously to improve results for our patients.

A successful hip arthroscopy does not guarantee you will never need a hip replacement, but it can help delay a replacement until you are older.  In some patients, they do experience permanent relief of their pain and dysfunction.

Our experts also manage other less common hip conditions when providing hip arthroscopy, including:

• Bursitis
• Gluteal tendon tears
• Hamstring tears (full or partial)
• Iliopsoas tendonitis
• Ischiofemoral impingement

A successful hip arthroscopy does not guarantee you will never need a hip replacement, but it can help delay a replacement until you are older.  In some patients, the repair will be permanent.