Recent Advances in Arthroscopic Hip Treatment

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Recent Advances in Arthroscopic Hip Treatment

• Erica Brinker
• VP of Strategy and Marketing

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Recent Advances in Orthopedic Surgery
One of the most exciting and potentially
beneficial recent advances in orthopedic surgery
has been the use of arthroscopy to repair
injuries of the hip joint. These techniques
have gained significant exposure as prominent
athletes such as Alex Rodriguez, Kurt Warner and
Greg Norman have undergone hip treatment
procedures. Many recreational athletes and
non-athletes have also experienced relief from
their hip pain with arthroscopic hip treatment
procedures. In addition, it is thought that the
hip treatment procedures may delay or prevent the
need for hip replacement.
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What is the Hip Joint
When orthopedic surgeons refer to the hip
joint, they are directly referring to the
ball-and-socket joint formed by the top of the
thigh bone (or femur) and the hip socket (or
acetabulum.) The top of the femur is a large
ball covered by smooth articular cartilage. This
femoral head is connected at an angle to the
main shaft of the femur by the neck of the
femur. The acetabulum is a deep socket formed
by the coalescence of the bones of the pelvis.
Most of the socket is covered by articular
cartilage. The labrum is a rim of rubber-like
tissue that is attached circumferentially along
much of the rim of the socket.
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What is the Hip Joint
It acts like a washer or gasket, providing
stability to the hip joint and distributing
stress. Its function is similar to the meniscus
in the knee and the labrum in the
shoulder. Other important hip-joint structures
include the ligamentum teres that connects the
femoral head to the acetabulum, the hip-joint
capsule that surrounds the entire joint and some
of the most powerful muscles in the body.
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Acute Injuries and Hip Treatment
The normally functioning hip joint is very stable
by virtue of its deep socket, and it absorbs high
forces as we walk, run and exercise. Because of
the powerful muscles that move the hip, simply
standing on one leg can cause the hip to
experience forces three times the weight of your
body. Activities such as running, weightlifting,
dancing, swinging a club or kicking a ball place
even greater stress on the hip. And, over time,
these stresses can cause the normal structures of
the hip to be injured and require hip treatment.
Acute injuries including tears of the labrum,
injury to the articular cartilage, tendinitis,
stretching of the capsule and tendon or ligament
tears can also require hip treatment.
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Impingement and Hip Treatment
The shape of the femur and acetabulum are also
implicated in causing injury to the hip through a
mechanism termed impingement. his
femoro-acetabular impingement (or FAI) is
abnormal contact between the rim of the socket
and the neck of the femur and commonly requires
hip treatment. Repeated contact in these areas
can be painful as the labrum gets pinched, and
tears in the labrum and articular cartilage can
develop. A femoral head and neck that is more
cam-shaped, rather than round, can also
predispose to impingement. Occasionally, a hip
treatment patient will have a combination of both
types of impingement.
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Impingement and Hip Treatment
The location of the hip treatment patients pain
from FAI and labrum tears is usually in the groin
and/or the side of the hip. The symptoms
usually worsen with activity and are alleviated
by rest. A catching or popping sensation in the
hip is often reported by patients who require hip
treatment, especially when arising from a seated
position, getting into or out of a car or other
activities that flex and rotate the hip.
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Diagnosis and Hip Treatment
An orthopedic surgeon who is an expert in the
diagnosis and treatment of hip problems is the
best person to evaluate for femoro-acetabular
impingement and labrum tears. This evaluation
will include a comprehensive history and a
physical examination, as well as x-rays of the
hip. X-rays can help determine if the hip has too
much arthritis, indicating that a patient would
be better suited for hip replacement. MRI scans
are very sensitive at detecting injuries such as
labrum tears, although, occasionally, an MRI scan
will overlook these injuries. CT scans and hip
injections can also be used to aid in diagnosis
and surgical planning.
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Advances in Arthroscopic Surgery
Within the last several years, the ability to
treat these hip conditions arthroscopically has
been developed. Arthroscopic surgery is a
minimally invasive technique. This means that
labrum tears, articular cartilage injuries, hip
instability and bone malformations in many cases
can be corrected through two or three small
incisions using a small camera called the
arthroscope. This is similar to arthroscopic
surgeries on other joints such as shoulder labrum
repairs and knee meniscus trimming.
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Advances in Arthroscopic Surgery
As this procedure has gained popularity among
orthopedic surgeons, specific surgical techniques
and instruments have been developed to address
the unique challenges of hip arthroscopy. For
example, hip labrum tears can be repaired using
small anchors inserted in the bone around the rim
of the acetabulum. The surgeon passes the
suture attached to these anchors around the
labrum. The anchors act like tent stakes,
holding the labrum in place against the bone
until the body can heal it in place.
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Advances in Arthroscopic Surgery
An essential part of any hip arthroscopic surgery
is addressing bone abnormalities such as the
cam-shaped femoral neck and the excessively deep
socket. These conditions are often present in
addition to labrum tears and indeed contribute to
the labrum tears developing. During the
arthroscopic surgery, these bones can be reshaped
to alleviate the femoroacetabular impingement.
Clinical studies have shown that these surgical
techniques provide excellent pain relief in most
patients. The benefits of doing the surgery
arthroscopically include smaller incisions,
quicker recovery, less pain and no overnight
hospital stay.
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About the Author
Erica Brinker is Vice President of Strategy and
Marketing at the CORE Institute, which began
practicing in 2005 to fulfill a vision of
orthopedic excellence encompassing the entire
spectrum of orthopedic sciences. Learn more about
hip treatment and other orthopedic topics by
visiting http//www.thecoreinstitute.com/.
 
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