What is hip arthroscopy?

A hip arthroscopy is a routine surgical procedure commonly used in the diagnosis and treatment of various hip pathologies. A small camera (arthroscope) and specialized surgical instruments are implemented in this minimally invasive surgical technique utilizing small incisions. The arthroscope allows the surgeon to methodically examine the bones, cartilage, labrum, muscles, ligaments, and tendons of the hip without a large incision while using the surgical tools to complete the necessary corrections.

Complex Hip Surgeon

Hip arthroscopy is a surgical treatment method that has been used to repair hip injuries for many years. Postless hip arthroscopy uses a specialized table that allows surgeons to act without a perineal post. This type of procedure can be used to treat many hip conditions including instability, arthritis, labral tears, and many more. Complex hip surgeon Doctor Ronak Mukesh Patel has extensive training and experience performing postless hip arthroscopy for patients in Houston, Sugar Land, and Pearland, TX. Contact Dr. Patel’s team today!

What are the benefits of hip arthroscopy compared to open hip surgery?

Patients that undergo a hip arthroscopy can expect decreased pain, smaller incisions, reduced risk of infection and blood loss, and quicker recovery during the procedure. Dr. Ronak Mukesh Patel, is an experienced, fellowship-trained orthopedic hip doctor, who treats patients in Sugar Land, Pearland, and the Houston, Texas area with minimally invasive hip arthroscopy.

Is hip arthroscopy new?

Traditionally, hip surgery employed a large incision and more invasive surgical methods to treat hip joint pathologies. Dr. Severin Nordentoft, a Denmark surgeon, first described viewing the inside of a joint with an arthroscope in 1912. Then, in 1918, Professor Kenji Takagi of Tokyo University used an arthroscope to visualize the inside of a cadaver knee and continued to modify the arthroscope throughout his career.  The first successful operating arthroscope was designed by a Japanese surgeon, Dr. Masaki Watanabe, in 1958. The 1970s and 1980s saw the evolution of fiber optics allowing advancements in surgical techniques. In today’s medicine, leaders like Dr. Patel make minimally invasive surgical repairs of the hip possible with excellent patient outcomes.

What is a postless hip arthroscopy?

The hip joint must remain open during a traditional hip arthroscopy to allow the safe passage of the surgical instruments into the hip joint. During the traditional arthroscopic approach, the joint is opened by pulling on the leg and positioning a large, padded post called a “perineal post” between the patient’s legs to provide counter-traction while the leg is pulled taught. This previously caused post-surgical soft-tissue and nerve-related complications in some patients.  A postless hip arthroscopy eliminates the need for the perineal post by using a special table with medical-grade memory foam preventing the patient from sliding and specialized padded boots to generate the traction necessary for this procedure. This technique is standard in Dr. Patel’s hip arthroscopy practice.

What are the advantages of a postless hip arthroscopy?

Postless hip arthroscopy improves patient outcomes by:

  • Eliminating soft-tissue and nerve-related complications from the use of a perineal post.
  • Allowing optimal x-ray views of the hip due to the lack of a large perineal post obscuring the image.
  • Decreasing the force through the leg and hip joint
  • Improving blood return to the brain and heart – allowing the patient to maintain a lower blood pressure during the procedure – due to the inclined position of the special traction table.

Not every hip specialist possesses the skills or knowledge to perform a postless hip arthroscopy; however, Dr. Patel has extensive training and experience with this surgical technique and exclusively uses this surgical approach over the traditional post.

What types of hip conditions can be repaired by a postless hip arthroscopy?

There are several acute and degenerative hip conditions that can be corrected by postless arthroscopic hip surgery, including, but not limited to, the following:

Hip Arthroscopy FAQ:

This refers to arthroscopic hip labral repair. Labral tears are often performed with hip arthroscopy to clean out the damaged labrum, repair the labrum with specialized surgical anchors and treat any underlying issues to improve hip function and reduce pain.

During a hip arthroscopy, small incisions are made around the hip joint, allowing surgeons to insert a camera (arthroscope) and specialized tools to directly visualize damaged hip structures and make any necessary repairs and correct abnormal anatomy that may be present.

Recovery is progressive and can vary from one patient to another depending on many factors such as age, medical problems, pre-surgery duration of symptoms and activity level, and severity of hip damage. Most patients start physical therapy the day after surgery along with a stationary bike, can resume light activities within a few weeks and are off crutches in 2-4 weeks. Return to work varies by the job demands but can be within 2-4 weeks for light work. Running is initiated around 3 months. A full return to sports, intense physical activity, and heavy duty work can take 5-7 months.

In the early stages of recovery, hip arthroscopy patients can expect early pain management followed by early physical therapy on post-operative day 1, stationary bike use on post-operative day 2, and then a gradual return to activities. Pain medications are prescribed but most patients have weaned off of them within a few days after surgery. They may need crutches for a few weeks and should initially avoid high-impact and twisting movements.

Persistent pain may indicate a failed hip arthroscopy. Incomplete relief of symptoms after hip arthroscopy surgery can be caused by multiple factors. These include older age, overweight, underlying autoimmune conditions, osteoarthritis, poor physical therapy, noncompliance with physical therapy, incomplete impingement resection, poor quality labrum, scar tissue, lumbar spine issues, nerve pain, and other factors. While not all risk factors can be eliminated, this highlights the importance of working with a fellowship-trained, experienced hip preservation specialist for best possible outcomes.

While based on individual healing times, most patients can resume sexual activity within 4 to 6 weeks if they avoid positions that put stress on the hip joint.

Since hip arthroscopy requires only 2-3 tiny incisions, each a half an inch long, scarring is minimal and fades over time.

The length of the procedure can vary based on the complexity of the case, but typically takes 1 to 2 hours.

Minimally invasive hip arthroscopy treats joint damage from impingement that can progress to arthritis. Total hip replacement is reserved for hip arthritis that is beyond what can be repaired with hip arthroscopy and requires a major surgery to replace the entire joint.

A multitude of factors can cause buttock pain. This is not common after hip arthroscopy and usually improves with physical therapy and/or injections.