Arthroscopy is a form of keyhole surgery, meaning it is minimally invasive and has a faster recovery time than traditional ‘open’ surgery. Using very small incisions and tiny surgical tools, hip arthroscopy is good for people who have certain conditions, such as a labral tear or a femoroacetabular impingement (FAI), but is not suitable for people who have arthritis in their hip.
The younger you are when you have an arthroscopy, the more likely it is to fix the problem so that it is no longer an issue. The more damage the condition has caused, or the later you present with the problem, the more likely you are to have residual issues and problems in the future with arthritis.
Your hip consists of a ‘ball and socket’ joint, where the top of your thighbone (femur) sits inside the ‘socket’ of your pelvis (this is known as the acetabulum). The labrum is the band of cartilage that runs around the rim of your hip socket. It acts as a cushion to your hip joint, as well as a bit like a rubber seal, helping to hold the top of the femur securely within the socket. When this band of cartilage is damaged, a tear can occur. These tears can be painful and disrupt your lifestyle. In some circumstances, the cause of your labral tear can increase the risk of developing osteoarthritis. I tend to see this more commonly in people aged 20 - 40, and it is slightly more common in men.
This is a condition in which extra bone grows along the femoral head and/or the acetabulum. These bone growths cause friction between the joints during movement. This can result in stiffness and/or pain in your thigh, hip, groin, or lower back, as well as a lack of flexibility in flexing your hip beyond a right angle. You may find that turning or twisting at your hips exacerbates the pain. Over time, if left untreated, the repetitive friction on the joint can cause damage to the cartilage, wearing the joint down much more quickly than normal.
When you first visit with me, we will talk about your symptoms and how your life is being affected by them. I’ll then carry out an examination of your hip, moving it into various positions to see where it is more comfortable and most uncomfortable. This will give me a good idea of what is causing your hip pain, but I will also arrange for any diagnostic tests needed to confirm the diagnosis and to determine the best treatment options.
If you haven’t already had an X-ray, I’ll arrange for you to have one here at Circle and it is likely I will also book you in for an MRI scan, as this gives me very detailed images of your hip joint and the surrounding anatomy, showing me whether there is any cartilage damage in the joint or any damage to the soft tissue structures around the joint such as the labrum.
Occasionally, I may also want a CT scan, and again this can be arranged at Circle.
Often when I see people with severe hip pain, they have already tried managing the pain through non-surgical (conservative) methods, such as painkillers, anti-inflammatories and avoiding the things that make it hurt.
While these can often be of help in many cases, there will often come a point where the damage to the joint progresses so much that conservative treatment options are no longer effective. In these cases, a hip arthroscopy may be deemed the best treatment option for you. Should this be the case, I will talk you through the procedure and explain what it will involve, how long it will take and what you can expect your recovery afterwards to be like.
Any surgery should only be considered once other treatment options have been considered/tried, and I will make sure you have all the information you need in order to make an informed decision about having an arthroscopy.
Hip arthroscopy is carried out as a day case, meaning you will be able to go home the same day. It is done under general anaesthetic and usually takes between 1.5 - 3 hours, although the exact time will depend on a number of factors.
Following your arthroscopy, you will have a small dressing over your wound. You will probably be a little sore around the hip, and this is completely normal.
Once you return home, you should be able to potter about over the next few days without issue, although you should take things gently and avoid excessive activity. Most people find they are able to return to work and normal daily activities within 2-4 weeks, although you need to be aware that you may have residual symptoms, which can take many months to fully settle.
I work in retail and have a very active job. A few years ago, I began to experience pain in both my hips. As many people do, I tried to ignore things as much as I could, but as the pain became worse, it got to the stage that I knew I should get some medical advice. Both hips were causing pain and discomfort, limiting what I was able to do. The pain got worse whenever I did more walking, and there was definitely a motion-related aspect to it.
I was fortunate to be able to talk with a number of consultants about best treatment options, but there was a bit of debate as to whether I would be better having a hip replacement or to have hip arthroscopy.
My personal preference was to delay hip replacement as long as possible, so that I didn’t run the risk of having it wear out and need replacing too early. One of the consultants suggested I speak with Mike Rigby about hip arthroscopy, so I arranged a consultation with him at Circle.
Mike was fantastic. He was very knowledgeable, and he gave me confidence that hip arthroscopy was the right decision for me. Up to that point I had been undecided, especially as I had been told a few different things by a number of consultants. Talking through my questions, concerns and symptoms with Mike, he was able to help me realise that hip arthroscopy was actually a very good option for me. It was great that it also matched my personal preference to delay the need for hip replacement surgery if at all possible.
Mike carried out the arthroscopy on my right hip in July and on the left one in October. While I could have potentially returned to work after around 2 weeks, I chose to take 6 weeks off each time. As my job is so active and involves a lot of walking, I wanted to make sure I had given myself enough time to recover from each operation before returning. Following my operations, I have found that walking seems more natural, more ‘right’.
I am really grateful to Mike for his expert help. Having been seriously considering hip replacement surgery, it was nice to be told that there was another option to consider. Where I had been unsure about what to do, Mike gave me the information and confidence to choose hip arthroscopy. I am glad I was advised (by another orthopaedic consultant!) to see Mike.