by Matthew Harris MD, MBA
Hip Arthroscopy has surged to the forefront of Orthopedics over the past decade. It always was, and will remain a technically challenging procedure that should only be performed by persons with formal training. This historically led many Orthopedic Surgeons to be wary of attempting this surgery in their patients. Little by little, great strides were made to advance not only our knowledge of techniques and capabilities, but also the development of hip-specific instruments that have today made this a very safe, and highly effective surgical treatment option as long as it is performed by a skilled surgeon.
Today, we have a greater understanding of all the indications for Hip Arthroscopy than ever before:
1. FAI (Femoroacetabular Impingement)
2. Labral Injury
3. Cartilage Injury
4. Retrieval of Loose Bodies
5. Treatment of Ligamentum Teres Injury
6. Treatment of Acetabular Rim Fractures
7. Staging of Disease / Joint Inspection
8. Treating Synovial Disorders (PVNS, Rheumatism, etc...)
Hip arthroscopy is a fantastic procedure that is performed through small incisions on the skin, through the use of a camera and instruments that are then placed into your hip joint. We will sometimes use a type of XRay image as seen above, to guide us as we perform different parts of the surgery. Because it avoids the much bigger incisions that were traditionally required for surgery around the hip, recovery is much faster for patients who instead undergo arthroscopy. In addition to that, there are lower likelihoods for post-operative infections, shorter periods of immobilization, and many studies will also argue less pain. A patient is placed onto a special bed with their foot in a special padded boot which is used to pull the hip joint open far enough to allow the surgeon to work in it. After the surgery, all patients then go into a specialized brace and begin an intensive PT program.
Not all patients have pathology that can, or should be treated through an arthroscope. As too often happens, when a new technique becomes popular, many surgeons grab that "Hammer" with the hope of hitting every nail that they come across. Unfortunately, if all you have is a "Hammer," you will not be doing the patient any favors by hitting their "screw." Dr. Harris' philosophy while training was simple. In order to truly offer my patients the very best in not just treatment options, but outcome, then it was essential to equip myself with both a "Hammer" and a "Screwdriver." Dr. Harris traveled and studied all around the world in order to be the only Orthopedic Surgeon in Florida with formal training in using both Hip Arthroscopy and Open Hip Surgery, and one of the very few in this country to do so. There are several limitations to Hip Arthroscopy that Dr. Harris will be happy to go over in detail with you during your visit. For patients whose conditions fall outside of the ability for them to be treated safely and effectively with arthroscopy, there are still plenty of options that remain.