Hip arthroscopy, often called a “hip scope,” is a specialized surgical procedure used to examine and treat various problems within the hip joint. This technique involves an orthopedic surgeon using slender instruments and a small camera to access the joint without requiring a large incision. This process allows for the direct viewing and repair of damaged tissue and bone structures inside the hip, resolving chronic pain and restoring mobility.
What Makes Hip Arthroscopy Minimally Invasive
Hip arthroscopy is minimally invasive due to the small size of the incisions, which are typically only about a quarter to a half-inch long. These small entry points, known as portals, cause significantly less trauma to the surrounding muscles, tendons, and joint capsule compared to open hip surgery. Reduced soft tissue disruption generally translates to less post-operative pain and a quicker initial recovery period.
The core technology is the arthroscope, a thin, flexible tube equipped with a light source and a high-definition camera. The surgeon inserts this scope through a small portal, projecting a magnified, real-time image of the joint’s interior onto a video monitor. This visualization guides the surgeon as they insert specialized miniature instruments through other portals to perform repairs. Instruments like motorized shavers, graspers, and suture passers are designed with long, narrow shafts to operate effectively within the joint space.
Common Conditions Repaired Using a Hip Scope
The hip scope is frequently used to address mechanical issues causing pain and limited movement, often in younger, active individuals. A common indication is Femoroacetabular Impingement (FAI), where abnormal bone growths cause the ball and socket to rub against each other. The surgery corrects FAI by reshaping the bone (osteoplasty), targeting excess bone on the femoral head (cam impingement) or the rim of the acetabulum (pincer impingement).
Arthroscopy also addresses labral tears, an injury to the ring of cartilage that lines and deepens the hip socket. A torn labrum causes clicking, catching, or pain; the surgeon can either repair the tissue using small anchors and sutures or remove the damaged portion if irreparable. The procedure is also effective for removing loose bodies (fragments of bone or cartilage floating within the joint) that cause mechanical locking or instability. A hip scope can also treat early stages of cartilage damage or inflammation of the joint lining, known as synovitis.
Steps During the Surgical Procedure
Hip arthroscopy begins with the administration of anesthesia, which may be general or a regional nerve block combined with sedation. The patient is positioned on a specialized operating table that uses controlled traction to separate the ball and socket of the hip joint. This distraction creates a small working space, necessary to safely insert instruments and visualize the joint surfaces.
The surgeon uses fluoroscopy (live X-ray imaging) to accurately guide the placement of the first instruments. They create two to four small incisions (portals) around the hip to introduce the arthroscope and working instruments. A sterile fluid is continuously pumped into the joint through a cannula to keep the area clear and expanded, which maintains visibility throughout the operation. The surgeon examines the joint structures, including the labrum, cartilage, and bone contours, to confirm the diagnosis and address all identified damage.
Repair work involves using a motorized shaver to precisely remove bone spurs from the femoral neck or acetabular rim. If a labral tear is present, the surgeon stitches the torn cartilage back to the socket rim using specialized instruments and bioabsorbable anchors. After the repair is complete and the joint is irrigated, the instruments are removed. The small portals are closed with a stitch or two and covered with sterile dressings. The entire procedure usually takes between one and two hours, and the patient often goes home the same day.
Recovery and Rehabilitation Timeline
Recovery from hip arthroscopy begins immediately, with most patients requiring crutches for a period to limit weight-bearing on the operated leg. The specific weight-bearing restriction is determined by the surgeon and depends on the type of repair performed, especially if bone reshaping or labral repair occurred. Patients are often placed in a hip brace for several weeks to protect the repair by restricting movements like excessive hip flexion or rotation.
Physical therapy is fundamental to recovery, often starting within the first few days after surgery. The initial phase focuses on managing swelling, restoring a protected range of motion, and activating the hip muscles. As healing progresses, therapy shifts to gradually increasing strength and stability, which is essential for safely returning to normal activities. While many patients return to desk work or light daily activities within a few weeks, returning to vigorous or high-impact sports typically requires four to six months of structured rehabilitation.