Hip Arthroscopy Appears safe, Effective for Management of Hip DisordersAuthors of a small study have found that hip arthroscopies can be an effective and safe tool for managing hip disorders. The advantages of arthroscopy include the minimal invasiveness of the procedure compared with surgery, short rehabilitation period following the procedure, and reduced interference for future surgical intervention. However, a good understanding of the appropriate patient group for whom arthroscopies would be a benefit is important.
Researchers reviewed the records of 35 patients (average age 32 years, ranging from 11 to 55 years) who underwent hip arthroscopy between April 2004 and November 2006. Each patient was followed up for at least six weeks following the procedure. For seven patients, diagnosis prior to the procedure was idiopathic (unknown cause) painful hip. Six of these patients had debris removed from the hip during the arthroscopy and one was diagnosed with intra-articular osteochondroma. When comparing the arthroscopy findings with the imaging tests done prior to the procedure on the remaining patients, 11 had a consistent diagnosis. The remaining patients had their diagnosis changed. For example, in five hips, a lesion that was seen by imaging, was not seen by arthroscopy. The authors of this study point out that in a previous study, the author found that these lesions were commonly overestimated through imaging tests.
Following the procedure, the patients underwent similar rehabilitation programs (full weight bearing with crutches as tolerated and simple range-of-motion exercises) following same-day discharge for 90 percent of the patients.
The authors conclude with the following observations:
- Patient selection is important in order to optimize the chance of successful outcome
- Although either general or spinal anesthetic may be used, it is vital that the muscles be as relaxed as is possible for the procedure
- Reasons not to perform a hip arthroscopy include a systemic illness, superficial infection, arthrofibrosis or ankylosis, non-progressing avascular necrosis, and morbid obesity.
The researchers also found that patients older than 55 years who had advanced degenerative arthritis did not do as well with the procedure as did the younger patients or those without the arthritis.
Riazuddin Mohammed and Marcus Green. Initial Experiences of Arthroscopy of the Hip. In Journal of Orthopedics. December 2007. Vol. 3. No. 3. e9.
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