Hip Arthroscopy.

Technique

Two to three 1cm incisions are made around the hip. Traction is applied to the leg, opening the joint space. A fibre-optic camera and fine instruments are introduced through the portals; saline distension is used to maintain visualisation.

The hip joint is examined, pathology addressed, and the portals closed with absorbable stitches.

Conditions treated

• FAI — CAM and pincer debridement
• Labral repair — using suture anchors to refix torn labral tissue
• Loose body removal
• OS acetabulae
• PSOAS tendon release
• Microfracture for small focal cartilage defects

Hip arthroscopy is NOT helpful for hip arthritis. Patients with established arthritis are better served by hip replacement or non-surgical care.

Labral repair technique

Torn labral tissue is reattached to the acetabular bone using small suture anchors. Where labral tissue is non-viable, debridement is performed instead. Where there is associated FAI bony abnormality, the bony impingement is corrected at the same operation.

Rehabilitation timeline

Full hip arthroscopy rehabilitation takes 12–18 months:

• Week 0–2 — one night in hospital, crutches with partial weight-bearing
• Week 2–6 — wound healing, gradual progression off crutches, gentle range of motion
• Month 2–4 — strengthening phase
• Month 4–6 — return to contact sport may be possible from this point
• Month 12–18 — full strength and confidence return

Driving and return to work

Driving: right hip — around 6 weeks; left hip with an automatic vehicle — around 2 weeks.

Work: office work from 1–2 weeks; physical work usually 6+ weeks depending on duties.

Risks

• Traction-related numbness — usually temporary
• Heterotopic ossification
• Infection — rare
• Joint stiffness