Arthroscopic Hip and Hip Replacement Surgery
Arthroscopic surgery is a collection of minimally invasive procedures designed around the use of an arthroscope, a long, flexible tube with a camera on the end. This tool allows the surgeon to visualize the site of surgical manipulation without making a large incision and opening up the joint. As a result, there is less risk and faster recovery associated with arthroscopic surgery.
The hip-joint (acetabulofemoral) benefits from a wide range of arthroscopic surgeries. Some of these operations include:
- Removal of bone spurs (impingement repair)
- Cartilage repair
- Loose body removal
- Torn labrum correction
Hip arthroscopy procedures are usually performed on an outpatient basis and recovery is accelerated compared to open-surgery patients. In fact, depending on the operation, the patient may be allowed to start rehabilitation immediately following surgery, stretching the day after or even the night of surgery. Range of motion can generally be reclaimed within a week and walking may be possible within two to three weeks.
It is important to note that arthroscopy will not be used to treat arthritis of the hip due to its limited effectiveness. Full hip replacement also cannot be accomplished using just arthroscopy.
All surgical procedures carry some degree of risk for the patient’s well-being, and arthroscopy is no exception. The normal surgery concerns are non-issues, such as infection, but the anatomy of the hip itself presents vulnerable nerves and blood vessels that may complicate the procedure. This contributes to the fact that hip arthroscopy has progressed and evolved at a much slower rate than shoulder and knee arthroscopy. The external joints are much easier to manipulate and contain fewer fragile entities.
A hip fracture is a break in the top of the femur (thighbone) where the bone angles toward the hip-joint. If the break occurs within two inches of the joint, it is called a femoral neck fracture. If it occurs between two and four inches from the joint, it is known as an intertrochanteric fracture. (A break further down the bone is classified as a broken femur rather than a broken hip.) Femoral neck fractures require more extensive surgery.
Hip fractures usually make it too painful for the person to stand. The leg may turn outward or shorten. They generally require hospitalization and surgical repair.
A person’s risk for suffering a hip fracture increases if he or she is over 65, female, or small-boned; has a family history of hip fractures; has osteoporosis or low calcium, which leads to bone weakness; smokes or uses alcohol excessively; is physically or mentally impaired; or takes medications that cause weakness or dizziness. Hip fractures are a common and serious problem for the elderly, for whom a simple fall in the home may be enough to break the bone.
Hip Replacement Surgery
The hip is a “ball-and-socket” joint where the “ball” at the top of the thigh bone (femur) fits inside the “socket” in the pelvis (acetabulum). A natural substance in the body called cartilage lubricates the joint. When the bone and/or cartilage of the hip becomes diseased or damaged from arthritis, hip fractures, bone death or other causes, the joint can stiffen and be very painful. A total hip replacement may be recommended for patients who experience severe hip pain and whose daily lives are affected by the pain.
In a total hip replacement, the diseased bone and cartilage are replaced with a metal ball and plastic cup. The artificial joint, called a prosthesis, may be cemented in place, may be cementless, or may be a hybrid of both. The surgery takes from two to four hours, followed by another few hours spent under observation in a recovery room. Patients usually enjoy immediate relief from joint pain after the surgery.
Physical therapy starts as soon as the first day after surgery with the goal of strengthening the muscles and preventing scarring (contracture). Therapy begins with the patient sitting in a chair and progresses to stepping, walking and climbing stairs, first with crutches or walkers and then without supportive devices. Occupational therapy and at-home exercises help patients learn how to use the prosthesis in everyday activities.
Total hip replacement is successful in over 95% of well-selected patients. On average, replacements last 15-20 years. Some patients enjoy full use of the prosthesis after 25 years or longer.
Read more about total hip replacement at www.medicinenet.com