Ok I need surgery... I have a torn labrum
Arthroscopic surgery of the hip is a surgical procedure that has been popular in Europe for the past 15-20 years, but has only recently gained popularity in the United States over the past 5 years. It is a minimally invasive means of evaluating and treating many common hip disorders, particularly hip problems in the young, active patient. Arthroscopic surgery of the hip evolved along the same lines as arthroscopic surgery of other joints of the body, particularly the knee and shoulder. It has become an alternative to open surgery which involves large incisions, long recovery times and increased patient morbidity. Because of its lack of popularity in the United States, few orthopaedic surgeons have advanced training in hip arthroscopy. However as the procedure is becoming more accepted and more popular, more and more surgeons are becoming trained in this area of orthopaedic surgery.
There are many indications for arthroscopic surgery of the hip. One such indication would be loose bodies that are present within the hip joint such as those that occur after traumatic injury of the hip. Also, tears of the cartaliginous labrum around the hip joint can produce incapacitating left hip pain necessitating arthroscopic surgery. Instability of the hip joint, either congenital or post-traumatic, is another good indication for arthroscopic evaluation and treatment of the hip. Also synovial disorders such as synovial chondromatosis or pigmented villonodular synovitis can be treated with arthroscopic hip surgery. Infections in the hip can also be treated with arthroscopic surgery to drain and lavage the joint. Studies to date have not demonstrated any symtpomatic improvement in patients with advanced osteoarthritis of the hip when treated with hip arthroscopy. It is not an effective means of treating or preventing the progression of osteoarthritis of the hip, although it will improve mechanical symptoms caused by loose bodies within the joint.
The technique of arthroscopic hip surgery involves several small incisions about the hip and the insertion of an arthroscope or a camera within the hip joint in order to directly visualize the intraarticular structures to determine the nature and extent of the pathology. One of the reasons that hip arthroscopy has not been very popular is that the bony constraints of the hip joint make arthroscopic surgery quite difficult. Intraoperative traction is necessary in order to open up the hip joint enough to allow the insertion of instruments. However, technology and instrumentation have advanced to the point that many procedures can be performed very routinely with a limited amount of traction time. These procedures include the removal of loose bodies from the hip joint, evaluation and treatment of articular surface lesions, removal of torn portions of the labrum, and shrinkage of the hip joint capsule.
The majority of patients who require hip arthroscopy are young, active individuals with a history of hip pain. Sometimes the onset of hip pain is traumatic after a fall or a motor vehicle accident. Other times, the onset is gradual and is caused by congenital problems within the hip joint. If someone has had a greater than six-month hip pain that has not improved with conservative treatment consisting of anti-inflammatory medications and physical therapy, they may be a candidate for arthroscopic surgery. As mentioned previously, patients with advanced osteoarthritic changes in the hip joint generally do not benefit from athroscopic hip surgery.
One of the obvious benefits of arthroscopic hip surgery is that is allows the surgeon to perform a variety of procedures within the hip joint with a minimal amount of postoperative morbidity. Open hip surgery involves a large incision, a long recovery time, and the necessity of being admitted into the hospital for postoperative care. Arthroscopic hip surgery is done on an outpatient basis. Frequently patients are on crutches for the first several days to the first week after surgery, and then undergo an aggressive physical therapy program in order to minimize the amount of swelling, improve their range of motion, and strengthen the muscles about the hip. The recovery from arthroscopic hip surgery now takes weeks when in the past, it would take months to recover from hip surgery that would involve a large incision and a long hospital stay.
As with any surgical procedure, there are risks associated with hip arthroscopy. Some of the risks are related to the use of intraoperative traction. As mentioned previously, traction is required to pull apart or open up the hip joint to allow for the insertion of surgical instruments. This can lead to postoperative muscle and soft tissue pain, particularly around the hip and thigh. Temprary numbness in the groin and thigh can also result from prolonged traction. Also there are certain neurovascular structures around the hip joint that can be injured during surgery. This requires the surgeons to have a detailed knowledge of the anatomy of the hip, and the relationship of the arthroscopic portals to critical neurovascular structures. By combining this knowledge with a certain level of technical expertise, and limiting the total amount of time in traction, the arthroscopic hip surgeon can perform a quick effective procedure, on an outpatient basis, with a minimal risk of morbidity or complications.
Arthroscopic surgery of the hip is a surgical procedure that has been popular in Europe for the past 15-20 years, but has only recently gained popularity in the United States over the past 5 years. It is a minimally invasive means of evaluating and treating many common hip disorders, particularly hip problems in the young, active patient. Arthroscopic surgery of the hip evolved along the same lines as arthroscopic surgery of other joints of the body, particularly the knee and shoulder. It has become an alternative to open surgery which involves large incisions, long recovery times and increased patient morbidity. Because of its lack of popularity in the United States, few orthopaedic surgeons have advanced training in hip arthroscopy. However as the procedure is becoming more accepted and more popular, more and more surgeons are becoming trained in this area of orthopaedic surgery.
There are many indications for arthroscopic surgery of the hip. One such indication would be loose bodies that are present within the hip joint such as those that occur after traumatic injury of the hip. Also, tears of the cartaliginous labrum around the hip joint can produce incapacitating left hip pain necessitating arthroscopic surgery. Instability of the hip joint, either congenital or post-traumatic, is another good indication for arthroscopic evaluation and treatment of the hip. Also synovial disorders such as synovial chondromatosis or pigmented villonodular synovitis can be treated with arthroscopic hip surgery. Infections in the hip can also be treated with arthroscopic surgery to drain and lavage the joint. Studies to date have not demonstrated any symtpomatic improvement in patients with advanced osteoarthritis of the hip when treated with hip arthroscopy. It is not an effective means of treating or preventing the progression of osteoarthritis of the hip, although it will improve mechanical symptoms caused by loose bodies within the joint.
The technique of arthroscopic hip surgery involves several small incisions about the hip and the insertion of an arthroscope or a camera within the hip joint in order to directly visualize the intraarticular structures to determine the nature and extent of the pathology. One of the reasons that hip arthroscopy has not been very popular is that the bony constraints of the hip joint make arthroscopic surgery quite difficult. Intraoperative traction is necessary in order to open up the hip joint enough to allow the insertion of instruments. However, technology and instrumentation have advanced to the point that many procedures can be performed very routinely with a limited amount of traction time. These procedures include the removal of loose bodies from the hip joint, evaluation and treatment of articular surface lesions, removal of torn portions of the labrum, and shrinkage of the hip joint capsule.
The majority of patients who require hip arthroscopy are young, active individuals with a history of hip pain. Sometimes the onset of hip pain is traumatic after a fall or a motor vehicle accident. Other times, the onset is gradual and is caused by congenital problems within the hip joint. If someone has had a greater than six-month hip pain that has not improved with conservative treatment consisting of anti-inflammatory medications and physical therapy, they may be a candidate for arthroscopic surgery. As mentioned previously, patients with advanced osteoarthritic changes in the hip joint generally do not benefit from athroscopic hip surgery.
One of the obvious benefits of arthroscopic hip surgery is that is allows the surgeon to perform a variety of procedures within the hip joint with a minimal amount of postoperative morbidity. Open hip surgery involves a large incision, a long recovery time, and the necessity of being admitted into the hospital for postoperative care. Arthroscopic hip surgery is done on an outpatient basis. Frequently patients are on crutches for the first several days to the first week after surgery, and then undergo an aggressive physical therapy program in order to minimize the amount of swelling, improve their range of motion, and strengthen the muscles about the hip. The recovery from arthroscopic hip surgery now takes weeks when in the past, it would take months to recover from hip surgery that would involve a large incision and a long hospital stay.
As with any surgical procedure, there are risks associated with hip arthroscopy. Some of the risks are related to the use of intraoperative traction. As mentioned previously, traction is required to pull apart or open up the hip joint to allow for the insertion of surgical instruments. This can lead to postoperative muscle and soft tissue pain, particularly around the hip and thigh. Temprary numbness in the groin and thigh can also result from prolonged traction. Also there are certain neurovascular structures around the hip joint that can be injured during surgery. This requires the surgeons to have a detailed knowledge of the anatomy of the hip, and the relationship of the arthroscopic portals to critical neurovascular structures. By combining this knowledge with a certain level of technical expertise, and limiting the total amount of time in traction, the arthroscopic hip surgeon can perform a quick effective procedure, on an outpatient basis, with a minimal risk of morbidity or complications.
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onomatopoeia:
hope you had a great weekend. and your hip didnt bother you too bad. 
khoos:
We HAVE to do that again!!!!!